In this episode, Lauren interviews two health practitioners: Dr. Yariv Rothman, the founder and clinical director of the Vitality Health Center, an integrative health facility in Santa Monica, CA; and Calliope Tsoukalas, nutrition and wellness coach. Together, they discuss integrative medicine, the role of nutrition in this practice, and its distinction from the disease model currently prevailing in the US.
Key links mentioned in this episode:
Calliope’s Paleo Chreats (including her Paleo Pumpkin Pie!)
In this episode, Dr. Rothman and Calliope reveal:
- how fatigue and chronic stress are rarely addressed in traditional western medicine
- how a lot of medicine today is symptom-oriented, but doesn’t treat the root cause; and how functional medicine is designed to treat root causes
- the brain-gut connection that is often not addressed in western medicine, and how calories don’t always equate to nutrients
- that western medicine can work in harmony with a more holistic approach to the whole patient
- Dr. Rothman’s favorite hypochondria joke (!!) – and that he very rarely comes across actual hypochondriacs, but more often meets patients frustrated with the system
- how patient education is empowering, and that in integrative medicine, the patient is an active participant in their healthcare
- that integrative medicine practitioners were into probiotics before they were cool
- that much of nutrition counseling is about teaching a patient to listen to their body, and working through trauma; and Calliope always recommends meditation and journaling as part of the emotional detox
- that often, (particularly female) patients have overdone portion control and are gaining weight because they are essentially starving themselves of valuable nutrients
- that not every quick-fix detox on the market is effective, but our bodies are designed to naturally detoxify – and we can better support detox from a root cause perspective
- that the scale measures mass, but doesn’t tell you what mass is composed of – so using a scale to measure the success of a diet can be both dangerous and psychologically damaging
- that adding foods back in after elimination is much more important than the elimination itself
- the high-food-sensitivity heavy hitters: dairy, gluten, soy, and corn (95% of which are GMOs)
- that it’s high time we review our farming methods, and educate ourselves as consumers about our food sources
- why Dr. Rothman ate all the bread he wanted while in France
- that the worst kind of invisible illness is the one not acknowledged by the doctor or the patient – or the one overlooked because nobody was searching for it
- the generational gap, and how it affects a patient’s approach to their personal care
- the gaps in our current healthcare model, and how insurance companies often limit care, constraining doctors in their abilities
- that medicare-for-all would very likely save everyone more money than the current managed care model
Lauren: On the show today we’ve got Dr. Yariv Rothman and Calliope Tsoukalas. Dr. Rothman’s the founder and clinical director of Vitality Health Center, which is an integrative health facility in Santa Monica. And Calliope Tsoukalas is a nutrition and wellness coach. So welcome, guys. Thanks for coming on the show today.
Dr. Rothman: Thank you.
Calliope: Thanks for having us.
Lauren: We’re going to talk today about nutritional and integrative medicine, and I want to start with the basics. Can you tell us what functional and integrative medicine is, and how these approaches are distinct from the current U.S. healthcare model?
Dr. Rothman: Integrative medicine really takes a look at the whole person — versus what we find in typical medicine. Allopaths (or general physicians) are typically focused on what their specialty is — which is great because we do need specialists. But for the most part, not many doctors tend to look at the whole person, really integrating all aspects of a person’s life — from what’s going on with them emotionally, what’s going on with them on a physical basis, what may be going on with them on a psychological basis. What’s their nutrition and diet like? What is their exercise program like? What are their sleep habits like? What are their bathroom habits like? These are fundamental integrative approaches — we look at patients and really take a look at the whole person. So not just dividing them into different body parts, but actually looking at how those body parts are integrated or speaking with each other. Generally we look at it from a subclinical level versus a clinical level.
Lauren: What does that mean?
Dr. Rothman: Well, good question. The clinical level is what most doctors look at today. It is the norm and it’s how it’s typically done. When you look at blood work, for example, you look at a blood work result and you compare it to the average norm on a bell curve that is seen at that lab, or throughout a particular area like the United States. So yes, there are particular things we look at in lab work to identify diseases. The problem with that is, when you wait that long to find actual changes in the body to indicate a disease, for the most part, that disease has been going on for quite a while — just unrecognized or unnoticed because the blood results haven’t changed enough to really indicate a disease model. So the interesting part is, if you don’t have any symptoms, if you don’t have any complaints, you go to your doctor and you say, ‘Okay, my blood work looks great. I don’t have any high cholesterol, everything looks wonderful with me. I’m not having problems sleeping, I’m feeling good. What could you tell me to make me more healthy?’ Most doctors would look at you, like, ‘What are you talking about? You are healthy.’ But as we know, there are a lot of illnesses and conditions that are not immediately detectable.
Lauren: That’s exactly why we’re here.
Dr. Rothman: And you can’t see them immediately. Yet, people are having symptoms. So, you get a lot of ‘Well, that’s all in your head’ when they can’t find something objectively on a lab test. Now that’s no fault of theirs. There’s a lot of things that have to be done in the medical field from a medical legal aspect. So they have to make sure things are in particular parameters before they can diagnose them.
Lauren: And this protects the patients and the doctors.
Dr. Rothman: But like I said, functional medicine really looks at the whole person and how everything is integrating together. And that can really make a significant change in someone’s health, wellness and lifestyle.
Lauren: How does that traditional Western care model work for patients? And in what ways do you guys see it falling short, especially as compared to that functional medicine model that you’re talking about?
Calliope: Especially, from a nutritional standpoint. With a lot of conditions, especially digestive disorders, a big part of what they do on the Western medicine scale is obviously prescribing medication. But what I have found is when analyzing the person and the whole scale, like Dr. Rothman said, I start to find that digestive disorders are usually paired with anxiety, depression, sleep disorders, chronic fatigue, chronic stress. So these things all play a really huge role in it, and Western medicine isn’t addressing those issues. So a lot of the people that I work with, I’m not just changing dietary needs … we obviously start there and discuss that, and talk about what they need, and food allergies, food sensitivities. And then we have to continue from there. It has to delve deeper than that. What is your stress level like? What are your daily habits and routines like, and analyzing all of those components that can really make a lasting impact — especially to where you’re not dependent on prescription medication.
Lauren: So would you say that the traditional U.S. model that we live with now is one that’s more likely to say, ‘Oh, you have a problem with this particular body part; we’re going to prescribe a medication for that.’ And then it doesn’t address the whole issue?
Dr. Rothman: Well, a lot of the experience, what my patients have told me about, is that a lot of medicine today is symptom-oriented. So they’re really chasing symptoms. So, ‘Okay, you have reflux, so we’re going to give you a proton pump inhibitor or some antacid. We’re going to shut down the acid temporarily in your stomach because you have too much acid.’ Well, why do I have too much acid? Why do I have reflux? Let’s address, what’s the cause of that reflux? Possibly, if it’s something that can be found out …
Lauren: Would you say, from what you guys are telling me about what functional medicine is, and the difference between that and the U.S. healthcare model, where there’s a cause-and-effect sort of difference there, that a lot of those root causes are actually happening in the gut — and then connected to emotions?
Dr. Rothman: Well, there’s definitely a brain-gut connection that a lot of people don’t address. Obviously, when we look at the human body, your body needs nutrients in order to heal, to repair; and to make hormones and to make your body function optimally. So yeah, in the typical Western world we think of somebody who is not getting enough calories or not getting enough food. But that doesn’t mean that they’re getting the right nutrition. Just because they’re getting in calories doesn’t mean they’re getting the right nutrition. And that gut inflammation can be happening without creating many symptoms that are considered out of the norm; typical symptoms would be gas or bloating.
Lauren: Welcome to my world!!
Dr. Rothman: So it’s not that it’s a terrible symptom to have where you have a lot of pain, or you’ve got some disability …
Lauren: It depends! It depends who you’re hanging out with, too!!
Dr. Rothman: (Laughs) What we want to address is, what is your bloating; why do you have gas? Is there a problem with digestion? Is there a problem with when you’re eating? So many different factors come into play.
Lauren: And that’s food sensitivity.
Dr. Rothman: That’s food sensitivity. So unfortunately, in the United States we function from a disease model. You’re only going to get treatment once we have a definite disease per se. But if you don’t have a specific disease, or nothing clinically is representing a disease and you’re not feeling good, that’s when we get into the invisible conditions. ‘Well, I don’t see anything wrong with your blood work. So I really can’t tell you why you’re fatigued, you should get more rest.’ ‘Well, I’m getting enough rest, doctor, I’m sleeping eight hours a day, you know; I’m exercising as much as I can. Why am I still feeling this way?’ ‘Well, maybe you need some therapy.’
Lauren: Again, I’ve been there!!
Dr. Rothman: When there’s nothing that’s specifically identifiable on a lab test, MRI, X-rays, or some other examination that can be done, then unfortunately, because you’re symptom-oriented or you’re looking for particular things on a lab result, you’re not going to do anything until something calls for that, medically. So that’s part of the differences of integrative medicine, which is looking really for the cause of the problem and addressing that.
Lauren: And the preventive care model …
Dr. Rothman: And the preventive care model, which is completely out of the norm. I mean, there is no preventive care model whatsoever. And we should be doing that. If we did that more often, we would curtail people from developing conditions and diseases. One that’s a rampant condition right now is type 2 diabetes. For the most part, type 2 diabetes is nutrition-related, lifestyle-related [and] can be addressed and changed — or at least mitigated, so you don’t have to take as much medication. But it’s so simple just to take a pill. And unfortunately, people don’t realize the long-term effects of just taking that pill and how that pills starts affecting other systems of the body as well. So then there’s another pill for the symptom that’s happening because of the side effect of the first pill. And then the second pill has a side effect, so you take another pill for that side effect and before you know it you’re 62 years old and you’re taking 12 different medications. So yes, if you indeed have a condition where your body is deteriorated to the point where it needs medicine, I’m definitely a proponent of that. I mean, if you have heart disease, and you have damage to your valves, and you need to thin your blood out — because otherwise you can develop a clot in your heart, and die — by all means. But what happened, what could we have done for that person up until that point?
Lauren: Do you think, also, that in a way, we’ve sort of conditioned ourselves socially to be a little lazy — especially when it comes to not only seeking the diagnosis or taking care of something before it becomes a problem, but also in terms of actually looking at diet and exercise and trying to make an effort to avoid developing something like diabetes?
Calliope: I think it’s more like people not being educated about what to do. So they’re going in to see the doctor … and of course you want answers, you’re not feeling well. And you mentioned gut health affecting emotions, which is huge. So you’re experiencing all this. The doctors don’t know what’s going on with you. Like Dr. Rothman said, they’re running the labs and ‘everything’s normal, everything’s fine, you’re fine.’ And you’re dealing with this. So, of course, you want an answer, because there is an emotional component of how it makes you feel. And when your digestion’s off, and if you’re under chronic stress or anything like that, that’s affecting your gut health. It’s leaching vitamins and minerals from your body. So you’re feeling extremely unwell. And you just want to go in and get an answer from the doctor and follow the doctor’s advice. So you’re listening to who you think is an expert. And if what they’re doing is prescribing medication or telling you everything’s fine, then you start doubting yourself or just following whatever regimen they put you on.
Lauren: And then how do you balance the occurrence of hypochondria in situations like that with the reality of invisible disease symptoms? What about other doctors in the U.S. system? How often is it [that] somebody’s like, ‘I’ve got a million things!’ and then is really just suffering from anxiety and hypochondria? And how often does someone really need help; and how do you, as functional medicine practitioners and doctors within the U.S. disease model, address that?
Dr. Rothman: That’s a good question and actually reminds me of a funny joke that the hypochondriac put on his headstone. He died at 115. And his headstone said, “I told you I was sick.”
(Laughs) Following up with what Calliope said, there is lack of information out there. And there’s also bad information out there. With the advent of the Internet, a lot of people are coming into the office and saying, ‘I think I have this condition because I have these four symptoms.’
Lauren: Which is not necessarily a bad thing …
Dr. Rothman: Right. To get educated, to at least have some background. So the advent of the Internet and the access to information that we have is actually a good thing because when you’re coming into a doctor armed with some level of information, I believe very much that I can discuss medical conditions with my patients in a manner that they can easily understand without using big medical words. Because my opinion is, if you really understand what’s going on with your body, then there’s a much greater potential for you to be compliant and do things outside of the office that are going to help you because you have an understanding of the ‘why’ — versus, just doing it because you’re told to do it … ‘Just take this, because that’s what going to help you get better’. So I’m very much into educating patients because that empowers them like any bit of information on any subject, right? If you get empowered, now you can really take steps and actions and be responsible for some of your health, too. So with respect to the hypochondriac, yes, there are people out there who are looking for something, or really there’s nothing going on with them. But as long as you know that every other aspect of their healthcare lifestyle is in place …They are exercising well, they’re sleeping well, excuse me – they’re pooping.
Lauren: We have talked about much worse than pooping on this show!
Dr. Rothman: (Laughs) …Then you can deal with that aspect. But I don’t find that very often. I’m not finding people coming in just looking for a problem. I’m finding people who are coming in who are frustrated, not getting answers.
Lauren: You guys have a functional medicine practice. But what do you think about someone who’s in a family medicine, internal medicine practice, and they have patients coming in and saying, ‘I’ve got A, B and C and D!’ Do you think there’s a higher rate of hypochondria in those situations? Or is it just people being misunderstood, and reaching sort of the edge of someone’s ability to care for them?
Dr. Rothman: I’m not sure. I was a nurse first before I got into integrative medicine. By license I’m a chiropractor, as you know, and I run the integrative aspect of our clinic, where we have an internist as well. So we do bring both sides together. It’s interesting. There are different things that people will talk to me about and won’t talk to Dr. Zlotolow about, the internist. And vice versa. They’ll tell him things that they don’t think that I can particularly address. So then when we talk to them together, we really show the person that integratively they can work together.
Lauren: It’s literally what the word says it is!
Dr. Rothman: So really there is a time for: ‘Hey, you know what, you’re sick. You have an infection and you need antibiotics. And while you’re on antibiotics, we’re also going to give you something that’s not going to kill every normal great flora and fauna that’s in your gut, which is going to affect your immune system as well. So we’re going to help you in that way.
Lauren: That’s good bacteria, bad bacteria…
Dr. Rothman: Now some internists are starting to look at that. But I would say 10 years ago, 15 years ago, when we first started talking about probiotics, most general practitioners were, like, ‘Yeah, whatever, poo poo, whatever.’ And unfortunately, there is an aspect to medicine … they’re constrained about what they can and cannot say, because there’s liability to it. We live in a litigious society where there are certain things that can cause an allopath to get into trouble. Especially if he’s doing something that most allopaths are not doing.
Lauren: What’s an allopath?
Dr. Rothman: A general physician, a general medical doctor.
Lauren: Thank you! You’re using fancy words!
Dr. Rothman: With those doctors, they don’t want to find themselves in court where they’re saying, ‘Well, why did you do this and not this for the patient when every other doctor that’s in your specialty did the latter?’ ‘Well, I was trying to do things naturally.’ That’s a problem for some doctors, right? Because you have to look at medical evidence before you make decisions.
Lauren: Natural doesn’t mean medicine.
Dr. Rothman: Correct. Not always. So that’s why again, you have to really listen to the patient. And that’s one of the things that I like to pride myself on. I spend sometimes too much time listening to somebody …
Lauren: He does! He spends so much time listening to us!
Dr. Rothman: But that’s where you get the real impact of how the person’s health or condition is affecting them. And then, what to do. Like, in your example, we looked at your blood work; we saw you had a particular condition …
Lauren: But even before then, we did a digestive survey, and you were like, ‘This looks like Hashimoto’s to me.’ You were the one who said it before anyone else did.
Dr. Rothman: And then we found evidence to support that. And then after we did find evidence to support that, you still ran into some issues with some endocrinologists questioning whether it was true…
Lauren: Questioning my sanity!
Dr. Rothman: But now you’re on a pathway to get well and hopefully that will continue, and so on and so forth, which is great. So part of the integrative work as well is also acknowledging and noticing what is not within your hands to deal with. And somebody who needs something else, some specialty. And finding the right doctor who’s gonna listen.
Calliope: Dr. Rothman had mentioned about educating the patient. And that’s a big part, I think, of integrative medicine, that the patient is an active participant in their health care. And when it comes down to feeling crazy, I mean, ultimately your health is your responsibility. And so you need that education to back you up. When you are in the room with the doctor, you have every right to ask questions. And if they’re telling you to follow a certain protocol or take certain medication, you have absolutely every right to ask why and be comfortable with that answer before actually proceeding with it.
Lauren: I certainly experienced this in the beginning, where I felt like I was shuttled between so many specialists. So you’re talking about a patient being an active participant in their health, and talking to you about the entire range of their care. Do you often have patients coming to you and saying, ‘I’ve been to this person and that person, and I’m not able to find an answer anywhere’? Are you dealing with frustration from clients in that way? Do you have to then have a greater bedside manner because of it? Or do you find that the model needs to change entirely in this country?
Dr. Rothman: It’s very important, what you said. From the musculoskeletal standpoint … and I’ll have Calliope address the nutritional aspect … but from a musculoskeletal point of view, yes, it’s frustrating to have somebody come in and say, ‘Well, I’ve been in physical therapy, and I’ve been to other chiropractors. I’ve done this, I’ve done that.’ It’s not that I’m going to do something so much better, and a procedure that another doctor already did. I’m now looking for what’s missing, right? What has not been done? What has not been looked at? What has not been addressed? A lot of the times, with people with musculoskeletal conditions, I actually look at their feet. I address their feet, see what’s going on with your feet … because your feet are your foundation for the rest of your body. So, how you’re laying on my table in the physical therapy aspect or chiropractic aspect. And I’m stretching you and mobilizing your spine and readjusting you …
Lauren: You have never looked at my feet. That’s a lie! He always looks at my feet! What color is my toenail polish??
Dr. Rothman: (Laughs) So again …! I look at what has been missed, what has not been looked at that could impact somebody’s structural models mechanically. And then a lot of times, that’s really where the problem is. So we address that, and all the other symptoms go away.
Lauren: Root cause!
Dr. Rothman: Right, root cause! Even integrative doctors sometimes get pigeonholed into what they kind of know, and they don’t really open the scope. That’s also why it’s great to have other disciplines in an office …
Lauren: Which is why it’s great at Vitality, because you’ve got physical therapy, chiropractic, integrative medicine, nutrition. Everything’s there.
Dr. Rothman: So we look at it from different disciplines, and when you put that together that gives you a really clear picture of what’s going on with somebody. And again, if we don’t know, we use specialists because that’s what they’re there for.
Lauren: I’ve had that experience with you, when I had nerve pain and you were looking at it and saying, ’It’s not connected to the bulging disc you have.’ And I ended up going and getting hot laser, and it totally took care of it. That was beyond the scope of what you were able to do, so you sent me to someone else.
Dr. Rothman: Right, and they addressed it after we realized what we were doing was not helping you. It was coming from where you were pre-diagnosed before, incorrectly, as sciatica, which it wasn’t, right, even though all the clinical picture typically was there for that condition. Then once we addressed that, and we saw it wasn’t getting better, we knew we weren’t treating the right problem. We sent you to laser. You got laser therapy; I think in two visits, it was gone.
Lauren: Yeah. I was very lucky.
Dr. Rothman: Right. Which is great. So again, it’s looking, listening.
Lauren: And what about from the nutritional aspect? Are you having lots of people come to you, Calliope, saying, ‘I’m so frustrated. I’ve been to a million people. Fix me!’
Calliope: They’ve done a bunch of diets, or they’ve done a bunch of detoxes before … ‘I’ve done that already. I’ve tried that already.’ And it is about listening, and like Dr. Rothman said, figuring out what’s been missed because sometimes the weight issues or the fatigue are not necessarily nutrition-related, specifically. And every body is different. So there’s no fit-all formula for diet and you have to listen to your body. And that’s a big part of what I do, too … really, how do you get the person to tune into their body and listen to their body instead of all the information out there. Because there’s so much information out there, and it doesn’t work for everyone.
Dr. Rothman: A lot of information that’s been out there for a long, long time, that’s mediated or controlled by different industries — like the dairy industry or the meat industry — there’s a lot of false information. For a long time, we were talking about low fat and how important low fat is, and stay away from fat.
Lauren: Yeah, good fats are good for you!
Dr. Rothman: Well, we went from low fat to high sugar because that’s what anything that low fat is – typically high sugar. But we were so concerned about cholesterol. Well, now we know that healthy fats are extremely important, right. They’re extremely important in the process of making hormones in your body, which is what cholesterol is used to do. So you have to look at the whole picture.
Calliope: Another thing that’s really popular … everyone’s worried about overeating and portion size. That became a big thing. I have a lot of people, especially women, who are under-eating, and they’re malnourished. And some of them even are overweight, even though they’re under-eaters.
Lauren: Oh, interesting …
Calliope: And you don’t realize that that can also have the same effect. You can gain weight because your body is holding on to the fat because it’s starving; it goes into starvation mode.
Dr. Rothman: It takes all the calories you’re putting in and holding on to them and storing them for a later source, and using your glucose stored in your liver … or affecting your cortisol levels, which is another part that’s really involved in issues with digestion, issues with stress. I mean, look at our chronic stress today. Cortisol is what helps us get up in the morning. It causes our body to release sugar from our liver into our bloodstream — so we can actually have some energy to get up and start moving around because we slept for seven hours. So technically, we’ve been fasting. So breakfast — “break the fast” — how many people do you know who don’t have breakfast?
Lauren: I’ve never been that person! A-plus for me!
Dr. Rothman: Or they have a stimulant to get to work, right? They’ll put in some coffee, which creates more of a cortisol release and affects your adrenal glands, which is what cortisol is released from. And that’s a flight or fight response. So now they’re affecting their metabolism as well. They’re affecting the thyroid because they’re stimulating themselves. So their body is not into digesting or into eating. And then by one o’clock they’re starving, and where they’re going to is that nice sandwich with potato chips, or a diet soda …
Lauren: And they’re crashing afterwards.
Dr. Rothman: …And by 3.30, they’re crashing and they’re dead. And by five o’clock, they can’t wait to get home, and now they’re hungry, too. And they’re eating everything and then doing what? Sitting in front of the couch not being active.
Calliope: Even the people who are under-eating but eating healthy … you have to give your body the nutrition it needs.
Lauren: And you have to address if there are issues in the gut, right, that are preventing you from getting that nutrition?
Dr. Rothman: That is correct, especially absorption. There’s a leaky gut syndrome that’s recently been brought into the news, and people are talking about it and there’s kind of hem-haw about it … is it really happening or not. And yeah, it does happen to certain people. So you deal with the lining of their gut, you deal with the lining of their small intestine and their large intestine, and you start dealing with how much water they’re taking and nutrients they should be taking in. And that makes for a significant change.
Lauren: And you also mentioned earlier about detoxing and diets, and I want to swing back around to that because, you know, the idea of being able to detox and the idea of dieting — as probably most women understand it — is like, you know, you choose a diet, you lose the weight, and then you go back to eating the way you were eating right? So in terms of diet and detox, from what I understand from working with you guys, is that the idea of detox doesn’t exist because detoxing is actually just being healthy, right? You can’t go on a juice fast and expect to clean our body out, right?
Dr. Rothman: Well, there are detoxes out there that are quick fixes. There are juice fasts that reportedly are giving you all the nutrients you need in juice. Something that Calliope does very well is educating the patient as to what’s happening with them and then cleansing out stuff that’s in there. Listen, we’re all exposed to toxins; we drink it, we eat it, we breathe it, we’re exposed to it in our water. We bathe in chlorine. So we’re getting toxins all the time. And our body has a great ability to detoxify. Thank God our liver has great ability to detoxify, our colon as well. But I try to tell patients, it’s like a glass of water. You know the first 10 years you get a little bit of water left over, and you detox some of it. But there’s still some left over, and then another 10 years it’s just a little bit more. Then another 10 years, a little bit more, and before you know it the glass is half filled with water. And that’s not what we want. We want it to be cleared out.
Lauren: And that’s also when we get the disease model … ‘I’m sick now.’ Now we fix it … when you need to actually go to the root cause instead of the actual symptom.
Dr. Rothman: Correct. So again, that’s where education comes into play a lot and that’s what Calliope is very good at doing … really empowering somebody so they understand. ‘Do you mean I have to eat every three hours?’ Yes, you have to feed your body. And then when you feed your body, all of a sudden you’re stimulating your metabolism. And now you’re losing fat, because your body doesn’t need to hold on to it anymore. Or you’re losing fat calories and maintaining muscle. And that’s another aspect that we like to address …a bigger problem than that four-letter word DIET is that word SCALE.
Lauren: That’s a five-letter word! Especially for women, right?
Dr. Rothman: It’s a five-letter word which is worse than a four letter word!
Lauren: There are too many letters in there! I need it skinnier!
Dr. Rothman: I hate the fact that people evaluate how well they’re doing on nutrition or on a diet by what the scale says. The scale is measuring a mass. It does not tell you what that mass is composed of. How much of it is lean tissue? How much of it is fat tissue? So if you’re starving yourself, your body won’t burn fat; it’ll burn muscle tissue. So you’ll lose “weight on the scale”, but you’re losing the most metabolically active tissue you have, which is bone and muscle. We want muscle. To use energy. But if you’re burning muscle as a source of protein, because you’re not feeding yourself well, you’re affecting your immune system. And you’re also making yourself more unhealthy. And you’re getting fatter, even though the weight on the scale says it’s getting smaller.
Lauren: And ultimately, it’s probably not sustainable.
Dr. Rothman: No, it’s not healthy. So that’s why you integrate different phases of nutrition. We have different plans put together to slowly bring patients to where they need to be.
Calliope: And they’re totally customized, too. Because like I said before, everybody is different. Every lifestyle is different. There are certain people that have a certain food they really love, and they’re going to have it, whether I tell them not to. So I need to work with them on something that is sustainable. That’s the most important part. Now, we might start with a cleansing portion where we’re doing an elimination diet depending on the toxicity level. We might have some supplements to aid that, depending on where they’re at. But then we’re going to gradually start adding foods back in. And that’s a bigger thing, adding in rather than taking away to make sure you’re getting the fresh fruits and vegetables that your body needs.
Lauren: And that’s what an elimination diet is, right … that you start with a clean slate then bring things back, and slowly, and see what works for your body?
Calliope: Especially the high food sensitivity items out there, like dairy and gluten and soy and corn. Which is another thing about education. Most people today still think corn is a vegetable.
Lauren: Nope. It has zero health value…doesn’t it just turn to sugar in your system?
Calliope: And 95 percent of it is genetically modified right now.
Lauren: So what about GMOs? Talk to us a little about that.
People can’t see this, but both of you kind of rolled your eyes! Nobody at this table is a fan of GMOs, so let’s talk about it!
Calliope: Well, you had asked one time, is gluten the devil? It does wreak havoc on a lot of people’s digestive systems. But bread is out there and bread has been around for a really long time, and I don’t know what the digestive issues were or were not back in the day when they were first eating breads. But we do know that there’s been an increase in these sensitivities, and a big thing that we have to look at is our farming methods — from seed all the way to shelf. A lot happens in that time. What happened to the seed before we planted it; what’s in the soil? How are you harvesting it? Are you using pesticides? What’s in those pesticides? Once you harvest it, how do you treat it? There are so many steps to the process that we’re not thinking about. And we don’t have any idea what goes on in that process. And peanut allergies … that’s been blowing up over the past few years. So I’m more concerned about: what are they doing to our food? And what are the effects of GMOs? And I think what we’re learning very quickly is that the food that we’re producing right now is not the most nutrient-dense, healthy product that it used to be, back in the day when we weren’t using all these chemicals on our foods.
Lauren: Do you think this is why a lot of people end up going for plant-based diets as well, because they know that they can grow a tomato in their yard and then eat that tomato — and there are fewer middlemen in a process like that?
Dr. Rothman: Definitely doing your own growing and creating your own garden for staple stuff is a great idea if you have the space for that. I’ll share a personal experience about gluten in terms of different foods in different countries. I was lucky enough to go with my wife to Paris. And on our trip to Paris, there was no way that I was not going to have French bread, and you know … butter, croissants!
Calliope: Don’t forget about the creme brûlée!
Dr. Rothman: (Laughs) Now here, when I eat those things that are high in gluten, I have problems. I have digestive issues. I have sensitivity to that. So I have digestive issues; I know what the result is going to be.
Lauren: I’m sure your wife does, too!
Dr. Rothman: (Laughs) Well, that’s why there’s a basement bathroom …
Lauren: (Laughs) Oh yeah, the man cave? It’s a basement bathroom. This whole time we thought they were watching sports but they’ve just been sitting on the sh***er.
Dr. Rothman: (Laughs) Well, there’s a TV there too, but the point is that when I went there and I did eat those foods that I typically have a problem with here in the United States, I had no problems.
Lauren: Why?? How??
Dr. Rothman: Because what we’re doing is we’re eating different types of wheat here; we’re eating dwarf wheat that’s genetically modified to grow a certain way, to be harvested faster, and so on — where, in other countries, they don’t do that. They don’t have genetically modified foods; they don’t have that type of wheat. So I didn’t have that issue there.
Lauren: Yes, people talk about eating pasta in Italy, that it’s a very different experience than eating it here, too. And so in the preventive care model — just to come back to these care models; I know we’ve been talking about food for a minute. But in the preventive care model versus the managed care model, and the different tests doctors use to determine whether someone has a disease … are there specific tests that you guys kind of swear by? Or is it on a case by case basis that you recommend certain lab work?
Dr. Rothman: Well, it’s on a case by case basis. The first thing you do, obviously, is you do general lab screening. So there’s what we call a Chem 18. You’re looking at liver function tests, you’re looking at cholesterol levels. You’re looking at a thyroid panel — but I like people to do a complete thyroid panel, not just a typical screening panel, which would be a TSH and a T4.
Lauren: Okay, what does a complete thyroid panel include?
Dr. Rothman: A complete thyroid panel involves TSH, T4, T3, T3 uptake. You might want to look at a TPO, if you think somebody might have some kind of autoimmune thyroid problem.
Lauren: Which was certainly my case. I remember sitting and scribbling all of this down in a notebook, months and months ago.
Dr. Rothman: And also looking at the relationship between all of those levels to each other. That’s something to look at, because a lot of times, as the body changes through different phases of a disease or condition … as you’re aware of, at some points with Hashimoto’s, the TSH (thyroid stimulating hormone) was normal; at other stages, it was low. At other stages of your condition, it was high. So just looking at that and taking a picture at that moment — which is really what blood work is doing, just taking a framework, a picture of what’s happening in your body at that moment — you have to also take a look at the whole thyroid, the whole picture. And as Calliope mentioned, what could be affecting the thyroid that may have nothing to do with it? Is it an adrenal problem? Is it a stress problem? And going back to what she talked about with trauma, it could be physical. There are a lot of emotional traumas that people experience. And they don’t really know that it’s affecting them physically, because they haven’t even addressed the emotional trauma that they’ve had, maybe for a long time in their life.
Lauren: We were talking about that the other day actually. I was talking to Calliope about your practice, and nutrition. And you were saying that a lot of the work ends up being emotional work, and unpacking a lot of what people are going through, and the traumas that they’ve been through. And you even talked about suggesting meditation to people, right?
Calliope: Absolutely. I talked about journaling, meditation, writing ghost letters — if there’s a relationship that was really strange or traumatic — and really releasing that. So when we talk about detox, really, a lot of it is mental and emotional. And we do have to take care of all the sides that comprise a person because they do manifest physically. It’s something like that that could be causing stress and anxiety — that you’re so accustomed to, you’re not really recognizing it as additional stress that has a huge impact on your rest and digestive states. Your digestive system is so closely related to any mental, emotional stuff that you have going on. So it has to be addressed.
Lauren: And a lot of people actually have legitimate issues where if they have an emotional issue – it manifests completely physically, right?
Dr. Rothman: Absolutely. And sometimes they don’t know that it’s really caused by a trauma that they experienced a long time ago, that they’ve regressed and even suppressed, and don’t even know it exists. That’s why talk therapy is so important. There are certain types of therapy…
Lauren: …like EMDR?
Dr. Rothman: Like EMDR, that’s extremely effective in bringing out that trauma from a subconscious level to a conscious level, so you can actually deal with it and then manifest amazing change.
Calliope: That’s another reason why I like to implement meditation into their lives, because it just gives you that mind-body connection. Especially if you’re doing mindfulness meditation, like Vipassana — where you start to learn about your body more, and then you become more aware of how these external factors and emotional states start affecting you physically.
Lauren: Absolutely. And talking about trauma now, what other invisible illnesses do you guys find to be most recurrent in your practices?
Dr. Rothman: Well, like I said, a lot of times what I address from a musculoskeletal level is what’s been missed. Or one of the big things that we look at is fatigue. A lot of people have fatigue and chronic fatigue. So we want to address where that’s coming from. That’s kind of an invisible illness in a sense, because most illnesses are really invisible; not many people walk around with a label on their lapel that says, ‘I have diabetes’. Or, ‘I have hypothyroidism’, or ‘I have headaches and migraines’, or ‘I have fibromyalgia’. So those are very common chronic conditions that will come in, because those are conditions that are typically treated for symptoms only, especially something like fibromyalgia. So you’re getting people taking certain biologics, or certain autoimmune-regulating medication …
Lauren: Or pain management medications …opoids…
Dr. Rothman: Or to reduce pain. So most conditions or illnesses are “invisible”. The worst ones are the ones that aren’t even acknowledged or even realized by the patient. Or the doctor, because they’re not looking for it.
Lauren: Yeah, that’s really interesting.
Dr. Rothman: One of the things that’s really an invisible illness, that not a lot of people are paying attention to, is, with the advent of laptops and tablets, and the wonderful phones that we have, smartphones, what’s really happening with adolescents, kids, and even adults is that they’re spending so much time on these devices, it’s actually affecting their necks. And it’s causing a condition called forward head posture, a condition where your head is no longer situated structurally over your center of gravity. So your ear no longer lines up from the side with your shoulder, in front of your shoulder. That’s happening because people are looking down at their phones a lot while they’re texting, while they’re Instagramming.
Lauren: (Laughs) Sorry, I really like Instagram! I’ve got a business to run. Leave me alone!
Dr. Rothman: (Laughs) I remember the first time I ever saw a laptop, I was around 20, 22 years old. I was using it for school. So I had it then. At that point, my spine had already matured, already developed. Now I’m seeing three-year-olds and four-year-olds and five-year-olds being babysat by tablets. They’re watching things on their tablets; their mom and dad are also on their phones, in the middle of dinner half the time.
Lauren: It’s a social problem as well as a physical one.
Dr. Rothman: It’s a social problem. Now the physical problem is, for every inch you move your head away from your center of gravity, you’re almost doubling the mass effect of your head — which weighs between 10 and 12 pounds.
Lauren: (Laughs) Oh, I thought the human head weighs eight pounds! Jerry Maguire was factually incorrect there?
Dr. Rothman: About 10 to 12 pounds! Depending on how young you are.
Lauren: I’m also sitting up straighter now, the more you’re talking about it. I’m sorry, spine!
Dr. Rothman: So that really accelerates degenerative processes and cavities and breakdowns that happen in the spine from a very early age on, while your kids are still developing. So that’s a problem that I’m seeing, and it’s a problem that’s going to propagate and get worse. It also starts affecting breathing, which affects concentration, which affects cognitive ability. There are a lot of multiple system effects that start to happen. So you need to pay attention to what’s going on with your kids. Not just what are they doing on social media. What are they looking at, what they’re observing, and who they’re interacting with. But how much time are they on these devices? From the blue light affecting their eyes … which is causing damage to their cognitive abilities, to their frustration tolerance to emotional stuff … these things that are on all the time are creating habits for them, even structurally.
Lauren: And also backpacks, kids carrying heavy backpacks to school?
Dr. Rothman: Kids are typically carrying backpacks that are heavier than 15 to 20 percent of their body weight. Which they should not be carrying. We have a program in our office — we take pictures of somebody, we actually show them structurally on a computer what they’re looking like and what’s going on with them. That’s measured, so we can actually see what postural deviations they’re having. And then we start talking about exercises and things you can do at home to start reversing some of these challenges. Now most women will think about the forward head posture, the manifestation of that causing a hump in the back of their neck. And that hump is part of the structural and tissue changes that happen with the stress of the head being in a forward position. So that’s a very, very important thing. And as far as invisible illnesses go, you don’t really see the manifestation of these conditions until you start having arm pain because the nerves in your neck are being affected. You start having stiffness and restricted motion. You start having headaches and muscle spasms. You start having those secondary symptoms, and now your spine is actually degenerated. So I ask people a lot, when was the last time you had your spine looked at? People look at me like I’m crazy! When was the last time you had your teeth looked at? ‘Well, I don’t want cavities.’
Lauren: Well, that’s someone who’s not afraid of the dentist.
Dr. Rothman: But “cavities” in your spine will happen as well. It’s not from bacteria necessarily, but from positions that we’re forcing ourselves into. First of all, six to eight hours a day in front of our computers. And then on our phones after that.
Lauren: And sitting in chairs that probably aren’t ergonomic.
Dr. Rothman: That’s a huge thing. We have to really educate people on what’s going on with them — from their sitting position, to their ergonomics at work … that’s not set up properly, even though they’ve had “ergonomic specialists” in. And what they’re doing at home as well, and what their kids are doing. So once they start being educated about it, and then they start really looking around them, you’ll see that this is not an epidemic. It’s a pandemic. Everyone is doing this; everyone is on their phones. So we teach them how to hold a phone differently to make a slight change in the position of their head — which is going to take stress off their neck, stress off their upper shoulders, stress off the back of their head, which usually causes headaches as well. And then start making those changes before they get to the surgeon, where now they have so much damage they need to get their spine fused. Or surgical intervention, which is the last thing I would want anyone to do unless it’s absolutely necessary. So that is a huge part of education that I’m faced with, with my patients all the time. Unfortunately, even the ones who are educated about it, for a while, they still come into the office doing the same things with their heads until I start really tagging them … saying, ‘Hey, you’re looking down again, you’re looking down again,’ and so on. Because it’s a habit. And habits take time to change. But that’s where the education comes in. So that’s a huge, huge invisible illness.
Lauren: And would people be able to find more information about this on your website? Is there a blog?
Dr. Rothman: Yes, on the website they can get information. I have a video on there that talks about forward head posture. They can come in for screening. We can take a picture of them and show them what their posture’s like; it’s non-invasive, it doesn’t hurt them at all.
Lauren: And if they’re not local to Los Angeles, would you suggest they look for a physical therapist?
Dr. Rothman: Yes, a physical therapist or a chiropractor who deals with posture, who understands it, who will deal with what we call upper crossed syndrome, which is one of the manifestations of a bad forward head posture. Your shoulders become rounded, you sink down …
Lauren: You see that with a lot of really tall people who are trying to be more approachable, too, right?
Dr. Rothman: Yes. You’re not breathing properly, you’re not breathing with full lung expansion … so, your lung expansion is not there, your breathing is not there. That has a cognitive effect on you …
Lauren: Which creates fatigue, which creates issues at work, and relationships. All of it.
Dr. Rothman: What I recommend is, every 15 or so minutes, I want them to change what they’re looking at and stare at something at least 30, 40, 50 feet away from them. So they start changing their gaze.
Lauren: And maybe get up and stretch, too?
Dr. Rothman: And obviously get their screens looked at, or adjusted properly, so that their position, when they’re sitting, is precluding them from bringing their head down, looking down at the screen.
Lauren: And I’ll say, from my point of view as well, with both my phone and my computer, and actually my tablet too … with all three of them, there are settings that you can put on that take out the blue light after a certain hour, right?
Dr. Rothman: Yes, that’s good. But it’s the positioning. The blue light’s affecting your eyes, which is not good. Also your sleep patterns. But the position of the screen is what’s causing havoc on your spine and your neck.
Lauren: And we talked about meditation a minute ago. And that’s one of those things that gives you that moment to be still, right? And I wonder about how often you come across patients who aren’t ready to do the work and how disciplined it requires someone to be in order to really tackle the work? So is a lot of your work also being able to manage personalities and be able to convince someone of what is the best course of action for their overall health?
Calliope: Well, I’m never feeling like I’m going to convince someone. I definitely feel like the person has to be ready for it. And you always know what’s best for you. And that’s why I say that the listening becomes so important because you have to be working with where they’re at, and where they’re coming from. So I can make recommendations, but if there’s any sort of resistance, I’m going to go another route. And I have had people who don’t want to meditate. They like the idea of it, but it’s just not happening. So what else would they do? And we start analyzing those things. Maybe they like nature so I can get them to make sure they have one hour a week where they’re taking a hike or walking. Or journaling is another really good one. If they are resistant to meditation, I can have them journal; it has some of the same benefits. But most people that I’ve worked with kind of dive into … whatever [works for them]…
Dr. Rothman: I’ve found that the resistance actually depends on the age of the patient … in my experience. I’ve found that older patients, usually in their mid-60s on, will tend to sway to looking at medication to resolve their issues. Where people who are younger are more involved in searching the Internet and getting information; they’re looking for a more holistic approach.
Lauren: So it’s generational.
Dr. Rothman: There’s an aspect of a generational gap to that because the information wasn’t available for the 65-year-olds at their time too …
Lauren: And the information wasn’t available, or was not what it is now…
Dr. Rothman: I’ve had patients that have frustrated me because I feel like I’m more interested in helping them than they are in helping themselves. And that’s frustrating from a medical perspective, because you’re trying to give as much information as you can and help somebody. But you get to a point where you realize you’re fighting a brick wall, and the person is just not ready to deal with the particular problem, or just wants to be on medication and have the symptoms go away and aren’t really caring about what the ramification of that is. That’s the frustrating part for somebody who really wants to be integrative and look at a person as a whole. So that’s frustrating for us. But you can’t help somebody more than they want to help themselves, so you give them the information and they have to go with it.
Calliope: You talked about discipline too, and what I’m thinking is, the people I work with will do most of what I’m recommending. However, they’re definitely doing it while we’re working together, and it’s not always followed up on once our program has ended.
Lauren: And that’s the thing, isn’t it? You have to keep following through with lifestyle changes.
Dr. Rothman: Correct.
Lauren: So what I’m wondering is, does a patient have to up-end their life entirely? Or can they have that donut once in a while, or sleep-in sometimes, whatever they need to do? … Permission for donuts!!
Dr. Rothman: If you ask my family, I give myself permission on the weekends to eat things that I would never, ever recommend anyone eat!
Lauren: And you then go to the man cave!
Dr. Rothman: (Laughs) Sometimes directly to the man cave! Listen, you have to live your life. But with respect to mindfulness, and with respect to changing your relationship with food and maintaining that relationship. That’s what the real result of a food program should be. Because, like you said, you can be on a diet and follow the prescriptive diet and lose the weight. But if you don’t change your relationship with food, you come right back to the original way you’ve been eating, and you just gain back what you had before — sometimes even more.
Lauren: So the number on the scale is not the reason that you should be “dieting”. It’s for your health that you should be doing it.
Calliope: The other thing is not judging yourself when you have that donut. There are people that I’ve worked with who are very strict with themselves, and those are the people who will yo-yo a lot. They will be very strict with themselves; they’ll come in to work with me and they’re ready to do the work. They do the work and they’re diligent about it … and then they fall off hard. And there’s a lot of judgment then that goes on there. You know, your stress about all those guilty thoughts that you’re having … that could be worse than whatever you’re eating.
Lauren: And you have to allow yourself the guilty pleasures.
Lauren: It’s like have the pleasure, find the joy!
Dr. Rothman: Sometimes it’s just a little coaching. If you look at the top professional athletes, they all have coaches. Michael Jordan had a shooting coach. Not that the shooting coach was teaching Michael Jordan how to shoot the basketball better; I would think that Michael Jordan had better skills. But you have a coach that’s behind you, that’s going to look at the things you’re going to be missing, and just kind of keep you back on track once in a while. So there’s nothing wrong with that.
Lauren: Particularly with regard to mindset.
Calliope: We all have blind spots.
Lauren: We talked about coaching and integrative medicine as a whole. I’m wondering now about the financial aspect of that because so much is covered, and so much isn’t covered in the U.S. healthcare system. So patients are often burdened with the financial responsibility for these so-called alternative therapies, and that sometimes includes nutrition counseling, right? So what do you suggest for people who feel financially restricted? What advice would you give for someone who really needs this help, but their health insurance won’t cover it or they need to find a way to make it work financially for them?
Dr. Rothman: It’s a very frustrating aspect of care for us as well, because I could be recommending something that I know would be very helpful for somebody, and they just can’t afford to do it. So to that end, we’ll do a consultation for them and look at questionnaires they fill out, and at least give them some basic advice they can follow to put them on the right track. But yeah, it’s very frustrating for both the patient and the doctor model trying to fix things. But I will tell you that if you start looking at what we really spend money on, and you start looking at a cup of coffee from Starbucks at $3.50 or $4 for your Venti, and you multiply that at two a day, and you start looking at that expense … before you know it, you’re spending $200 and $250 a month on coffee because you need to be awake. So maybe you can take some of that money and apply it towards a nutrition plan or even a payment plan that we offer patients to pay off their balance in time. But at least be on the right track. So it really comes down to making your health a priority, because at one point or another, it’s going to cost you money — either being on medication and co-pays for the disease you have developed, or surgery that you need to have because now, God forbid, you’ve developed cancer, or …
Lauren: Time off from work.
Dr. Rothman: Time off from work … it’s going to come around in some form or another, the cost. The problem is, are you going to wait to the point where things are broken down so much that you can’t repair them — because our body gets to a point where it’s so broken down that we have a disease, we have a condition, that’s not repairable, only manageable, and that’s frustrating too. But in that case as well, manage it.
Calliope: I just want to piggyback as well … it’s more frustrating when we accept insurance at Vitality Health Center and nutrition is not covered under that. So there are a lot of patients who could get more out of their care if they’re doing physical therapy or chiropractic care, but a lot can also be done with nutrition to help heal, like anti-inflammatory diets. And they’re not getting the full benefit of that because they’re used to their insurance covering. But I absolutely agree that we have to find the money for those things. Because if you don’t have your health, you don’t have anything.
Dr. Rothman: And inflammation is the key to dealing with every single chronic disease that we know of today. On a capillary level, on a vascular level, and even on a chemical level — there’s inflammation involved. If we can modulate, mediate inflammation and immune response in our body, we would live a very long time. So yeah, those things are extremely important to look at and it’s based on what is a predominant motivation for you in your life. And for some people, like addiction, it just takes for you to hit bottom before you get up and say that’s it, I’m not going to take this anymore, and I’m going to do something about it and take responsibility.
Lauren: But aside from taking personal responsibility, how much of that responsibility belongs to the state? Is this a change that needs to happen in our health insurance system?
Dr. Rothman: Unfortunately, again in my opinion, we live in a world where medicine is predominantly regulated by the pharmaceutical industry. Doctors are constrained as to what they can and can’t do by insurance companies, sometimes. And managed care has really taken a lot of the doctor’s personal “investment with the patient” because he or she is curtailed by what’s covered or not covered. That’s unfortunate. In the beautiful country that we live in, and the kind of resources that we have here, it’s unfortunate that we have so much suffering from lack of nutrition, or homelessness or drug issues. And a lot of that is perpetuated by what people go on when they have the surgery and they’re on pain medication, which is normal. But then they keep getting medicated, and then those meds don’t work anymore so they need to get a different medication that’s a stronger opiate. And then their insurance runs out, so they can’t get opiates anymore and now they’re addicted. And now they go on the street and they get drugs from the street, and then that creates a whole other problem. So yeah, it’s unfortunate that the powers that be, the big corporation in the sky, is regulating what can and cannot be done. And that’s why a lot of doctors are developing more boutique practices. They’re realizing that patients will come in and take care of their health once they realize the importance of it, whether or not the insurance covers it or not. We do a lot for patients in our office that is covered by insurance. We also give away a lot of stuff because we’re concerned about patients; we’re kind of like a family, we really care about them.
Lauren: That’s very true. But that’s not true of every practice either. And how often do you see patients ending up on government assistance because they can’t afford their own care by the time they’ve gotten to you? And I say that with the knowledge that you may not be the first stop for a lot of patients, who may be coming to you after they’ve been through the disease model system.
Dr. Rothman: I get more of: Well, it’s in your head. They’ve been to lots of doctors who say that. Versus, ‘I’m on disability.’ Yes, I’ve had patients who have had car accidents and other terrible traumas. I had a patient who was in a car accident, and it brought back trauma from an accident she was in before, where she lost her husband and her unborn baby at the same time. There are incidences that will trigger all of that to come back and create a major problem for them — emotionally, mentally, psychologically, physically — and they can be on disability. But most of what I get is, ‘I’m told it’s in my head, and I know it’s not in my head. There’s something wrong with me.’
Lauren: So it’s not so much financial problems, because a lot is covered with you as well.
Calliope: But I have definitely seen financial issues. That’s more so because their health insurance doesn’t cover nutrition. And I have noticed a lot of the people who definitely have chronic stress – it’s affecting all the systems of their bodies. And they’re usually the ones with anxiety, depression, insomnia, chronic fatigue; they’re the ones that are not able to afford to do a program with us. We do consultations with them, as Dr. Rothman mentioned before, just get them on the right track, to give them some advice based on the scan results that we get in their questionnaires. Hopefully they’re able to at least make some adjustments.
Lauren: And would you say that you advocate for a change in the current model that we live with, in order to address these concerns?
Dr. Rothman: Oh, absolutely. I think in the long run the cost savings would be astronomical.
Lauren: If we covered everyone?
Dr. Rothman: If we covered everyone, and if we really work from a health care model, not a disease care model. If we did that, and educated patients, I think we’d be in a much better position. Correct me if I’m wrong, I’m not sure when the research recently came out. But the latest is that our mortality, morbidity rate — as far as an advanced nation, a superpower — in terms of birthing babies, is extremely low compared to other countries. And the research showed that there was uncontrolled bleeding or uncontrolled blood pressure that wasn’t really monitored properly, and has caused the statistics where we’re really paling by comparison to other countries. So for all of the money that we have, and all of the influence that we have and the opportunity we have in this country, I don’t think we’re on the right path as far as medicine, as far as general healthcare is concerned. We’re pushing more and more and more towards that disease model.
Calliope: And I think it takes a little bit more than just covering everything. We were talking about the pharmaceutical companies’ influence and all the regulations. I think it would take a whole upheaval of the system to really make it work.
Lauren: Do you guys see that happening in our lifetimes?…Oh, that’s so sad! I want to be optimistic!
Dr. Rothman: I would like to be optimistic to think that with people being more educated, that demand from “the grassroots little people”, which is all of us, that would maybe make some changes. But my fear is that the influences of money and power and certain industries are what really regulates what happens and what doesn’t happen. And that’s just the way it is. So again, we’re still responsible for taking our health into our own hands. Ultimately, we’re the ones that are going to be suffering with the condition, not the pharmaceutical executives. Again, I’m not saying that all pharmaceuticals are bad.
Lauren: Yeah, a lot of them are great but a lot of them are not great.
Dr. Rothman: A lot of them can be deferred or reduced with the right kind of information and treatment.
Lauren: How do we keep the dialogue going then? How do we continue to keep this conversation open? So that maybe if not our generation but our children’s generation will actually benefit from more care?
Dr. Rothman: Oh, you just hit it on the head. You start off with our generation and our kids.
Calliope: Yeah, and I think how we live is the example. And how you keep the conversation going is, you keep talking about it. You keep sharing, so that you’re continually educating and making those harder decisions that not everyone is making. And voicing your opinion, and sharing with people what you’re doing. On our film set last month, it was a paleo set.
Lauren: And top three tips for someone who thinks they might have something off, or might be suffering from an invisible illness?
Dr. Rothman: Okay, I’m gonna go with the top three indulgences.
Lauren: I already know what your number one’s gonna be!
Dr. Rothman: Chocolate. Anything with chocolate. Chocolate ice cream. Chocolate cookies. Chocolate, chocolate.
Lauren: Do you have a favorite chocolate? Is there a healthy chocolate that you like?
Dr. Rothman: Dark chocolate, I prefer dark chocolate. But any chocolate actually. Equal opportunity chocolate lover. If you would like to get me in trouble. If you want to get me in trouble, you can put a bag of barbecue potato chips in front of me and that would be like crack. So yeah, potato chips, chocolate, and the other third one which is right on the tip of my tongue … it’s very clear for me … is ice cream. Ice cream for me is an indulgence, and coupled with chocolate …
Lauren: So your three indulgences in health are food-related. It’s not like, ‘Oh, I go to the spa and get a massage,’ right? It’s food. They say the way to a man’s heart is through the stomach!
Dr. Rothman: Absolutely! But three tips… first of all, speak to your doctor. Go see him, get some testing done to rule out the obvious medical problem that could be there. Seek help from your community; there’s a lot of stuff online. Put your feelers out there. Seek out the doctors that are going to listen and spend time with you.
Lauren: That’s the biggest thing, isn’t it?
Dr. Rothman: And then take some responsibility. Empower yourself, educate yourself, get information. See through the information and make sure you’re getting it from legitimate sources.
Lauren: Do you have any particular legitimate sources that you would recommend?
Dr. Rothman: There are different websites out there that offer different information …
Calliope: You can check on our blog!
Dr. Rothman: We offer some really good information on our blog … not to toot our own horns!
Calliope: (Laughs) Not that I write it or anything!
Lauren: She’s not invested at all!
Dr. Rothman: But get information from legitimate sources. Don’t go on some website that’s created by Joe Schmo. Go on something that has references on it. Look up those references.
Lauren: Seek truth, is what you’re saying!
Dr. Rothman: Seek truth, seek information. And go to your community. Go to healthy places; there are a lot of healthy communities out there. And find the right doctor that’s going to listen to you. It’s okay to leave a doctor and find somebody else that’s going to work with you — if they’re not giving you what it is you feel is really conducive to your health, and not listening to you.
Lauren: That’s huge, though, isn’t it? Because a lot of patients aren’t empowered to be able to walk away from a practitioner if they’re not helping them. So what you’re saying is, if it doesn’t feel right, go.
Calliope: I’ve actually never done that.
Lauren: I only did that for the first time this year. It’s a big deal.
Calliope: Yeah, because I just got frustrated and then stopped going. Definitely top three tips … you have to get the basic panels done, the basic tests done, and go to your doctor. And research your doctors. That’s a big thing. Don’t just choose whoever is randomly assigned or everyone you know is using. Do some research. The Internet is full of reviews and information about your doctor. So if you are not happy with your doctor, it’s very easy to source someone you might be more compatible with.
Lauren: And even Yelp and Healthgrades are great for that.
Dr. Rothman: But be careful because you realize those are personality driven; people will have their own feelings and thoughts, and a lot of times you don’t get the other side.
Lauren: Yeah, but I found you on Yelp.
Dr. Rothman: Oh, well …! So again, take the information with a little grain of salt. Be smart about it. Connect with your mind and your body; be smart about it.
Lauren: That’s what some of us are trying to do. So it’s hard to make the mind-body choice when you’re not fully in control of it, isn’t it?
Calliope: The other thing is, you can also go to an integrative facility or an Eastern medicine facility as long as you vet them and you know about them. So you have to do your due diligence and do the research. But you can source someone who uses more of that alternative medicine, and bridge the gap that way.
Lauren: And find someone who takes your insurance if you can.
Dr. Rothman: But I want to know, what are nutritionists’ indulgences?
Lauren: I know! I want to know about that, too!
Calliope: One more tip! And actually this one’s the first one in terms of importance: Setting up a personal care routine and really being honest with yourself about your lifestyle. Is it conducive to healthy living? What is your sleep schedule like? What are your hobbies like? And making that time for personal time, personal care, personal self-care.
Calliope: It’s huge. It’s really important and you have to be incorporating those things into a daily routine.
Lauren: Absolutely. So what are your top three indulgences? And they don’t all have to be about food, but I want to know about this! The top three things that maybe you shouldn’t do. Or that are like really good for you.
Calliope: I like going to the spa, but I want to do the works though … facial, massage, back scrub. I want the whole thing.
Lauren: You’re my kind of lady!
Calliope: Not just going in for “a service”. I want the $1000-a-day package!
Lauren: (Laughs) I’m really happy for your boyfriend. I hope he knows about this!
Dr. Rothman: I want to know the food indulgence! That’s a common thing … what lady doesn’t want the $1,000 massage makeover, the star treatment. I want the food stuff because she’s like the food Nazi!
Calliope: Okay. It kind of varies by my mood. But I’m always game for, and I kind of lumped them together because they’re both custardy: creme brulee …
Lauren: She brought that up before!
Calliope: Yeah, I did. And I want mine with whipped cream and fresh berries.
Lauren: Oh, she’s not messing around.
Calliope: I’m not, I’m not messing around. And/or: a chocolate eclair. I love the choux pastry. I love the custardy filling. And then you also get the chocolate. So it’s like win, win, win.
Lauren: You two can have an eclair/creme brûlée party at the office! You can sprinkle some barbecue potato chips over the top!
Lauren: That actually sounds absolutely gross to me!
Dr. Rothman: And we can top it off with some pizza!
Calliope: And then my very favorite pie, which is pumpkin pie. And actually with that one, I do prefer paleo because I make an amazing paleo pumpkin pie …
Dr. Rothman: Really!
Calliope: …with a pecan crust.
Lauren: That’s awesome. You’d better send me the link to that! We can link to that!
Dr. Rothman: So ultimately, we like to use the hashtag for all we discussed, which is: Go health yourself.
Lauren: Ohhh! Go health yourself! And go frost yourself, too!
Dr. Rothman: And sugar scrub yourself, too!
Lauren: Guys, thank you so much for coming and being on the show today! And if anyone wants to find you, how would they find you guys on the wide world of the webs??
Dr. Rothman: They can go to to TheVitalityHealthCenter.com. That’s our website. They can look us up in Santa Monica; we’re right on Santa Monica Boulevard and 23rd Street. Or they can give us a call at 310-396-3635. I’ll be more than happy to speak with them.
Lauren: Awesome. Thank you so much, guys.
Calliope: Thank you for having us. This was really fun.