Rx Life: The integrative solution to keep kids healthy

 

This year marks my 20th as a pediatrician. Through these years, caring for thousands of children, I’ve been so fortunate to witness the vast majority grow into happy and healthy young adults. And, as the families who’ve worked with me since the beginning will testify, I’ve also evolved. Changes in how I practice are due, in part, to wisdom born of experience, but equally, I believe, as a reflection of the tremendous shift in children’s health.

I emerged from pediatric training extraordinarily capable of handling the most extreme emergencies. Put me in any acute care situation, I was your guy. I had a well established toolbox for any situation. Or so I thought. Once I started in primary care practice, I realized pretty early on that I was woefully unprepared for my chosen profession. Keeping children healthy, that was my main task; in fact, it was the very reason I chose (or was called to) pediatrics. I had no clue how to answer the most basic, common questions I faced. “Doctor, how and what do I feed my baby? He won’t sleep, what should I do? She seems to be getting sick all the time, can I do something to prevent this? He is not walking, she is not talking… now what?” I was also seeing a remarkable rise during my first decade of practice in the prevalence of many chronic conditions — autism, anxiety, ADHD, asthma, allergies, obesity, and diabetes. My approaches — simply mirroring the standard of care as I was trained in — were a carefully selected hodgepodge of quick-fix pharmaceutical solutions. This “one ill — one pill” paradigm stopped serving me, and my patients. The only credit I can take for changing course, upon reflection, is that I stopped long enough to listen to those particularly passionate families trying to teach me what physicians for thousands of years knew and, in the space of a couple hundred of years, forgot. The most effective, safe and cost-effective approaches to keeping our kids well remain the simplest and most accessible: a series of lifestyle prescriptions I began to call the “Rx Life” solution.

Why “Rx Life”? It was naturalist and author Rich Louv who I first heard co-opt the conventional prescription model, describing the healing power of nature as something doctors should literally prescribe for their patients. This was one of those “aha” moments for me, and I was immediately struck by the vast potential of his idea. What if we deliberately reframed the prescription model to teach children and families several simple yet incredibly powerful tools for living a healthy life? I thought about the basic approaches I discussed with my patients and their parents each and every day, the ones that I knew worked in practice. These lifestyle prescriptions are the pillars of an integrative paradigm that creates true health and wellness. Importantly, this approach is collaborative and actively encourages patient participation, putting kids back in control of their own health. I’ve profiled below the seven prescriptions I believe are critical in empowering families to make sustainable changes, inspiring all of us to create the future we deserve.

1. Rx Food: Eat real food, not a long list of processed ingredients mashed together. Teach your children that food comes from the earth, not from a can. Grow and prepare your own food. Cultivate a garden or a farm. Buy and eat locally-grown, chemical-free food. Teach your kids that eating is a mindful process, not only about ingesting calories but also about nourishing your body, mind and soul. Eating is and ought to be a community activity.

2. Rx Activity: Move your body. Start with something — any amount, as much as you are able, and build on that foundation. Get your heart rate moving and see what it feels like to be so active that even your hair sweats. Support school recess and encourage free, unstructured play.

3. Rx Rest: Make sleep a priority. Create opportunities for rest, especially for teens; they always need far more sleep than they get. Instill good sleep habits from the beginning. Create a quiet, calm place for restful activities. Take time to simply be. Unplug and recharge. Value downtime. Remind your kids — and yourself — that it’s OK to stop.

4. Rx Nature: Get outside. Take a hike. Go jump in a lake. Explore the nearest nature center or national park. Experience the transformative power of the natural world and refuse to suffer from nature deficit disorder.

5. Rx Mindfulness: Be here now. Pay attention to the process. Realize that the most important time is now, the most important person is the one you’re with and the most important thing to do is what you are doing right here, right now. Be willing to sit in the mud until it settles and the water clears. Accept that you will never make all the stress in the world disappear and help your children build their stress-coping toolboxes. Take time to look someone in the eyes, listen to her story, and let her know that you hear her.

6. Rx Creativity: Be silly. Dance like no one’s watching. Color outside of the lines. Build something with your own hands. Paint using every color you’ve ever known. Make up stories and tell anyone who will listen. Sing a song — any song — and sing out loud, proud and strong.

7. Rx Connection: Realize that we are all connected, and that our relationships make us stronger and healthier. Be courageous enough to be vulnerable, and let others see you for who you really are. Look through someone else’s eyes as if they are your own.

(originally posted for Thrive Global)

“I am Thankful for…”; Answers from 7 Health Care Professionals

LR cartoon

I was honored to be one of several health professionals asked by athenahealth to contribute to their Thanksgiving blog post.

The question I was asked: “What are you thankful for in Healthcare?”

My answer was broad, with respect to “healthcare” with a capital “H.”  Honestly, I’m not so thankful for a lot of the administrative gobbledygook (pun intended) that we all have to deal with, but it is what it is.  However, I do have incredible gratitude for the ability to wake up, each and every morning, and bear witness to families’ lives and be inspired by special, amazing children.  All of them.

My official answer:

“I am grateful for my patients and their families, who always remind me what is truly meaningful in life. Caring for children, with the explicit goal of working together for their optimal health, keeps me firmly engaged in the present moment. For that, I am forever thankful.”

To read more, see the original post here.

Happy Thanksgiving!

The Rx Life Solution

“Insanity is doing the same thing over and over again and expecting different results.” – attributed to Albert Einstein

The Problem

Americans are sicker than ever before, and despite throwing tons of money at the problem, we continue to be sicker than citizens of most other affluent countries. According to the Institute of Medicine:

“The United States is among the wealthiest nations in the world, but it is far from the healthiest. For many years, Americans have been dying at younger ages than people in almost all other high-income countries. This health disadvantage prevails even though the U.S. spends far more per person on health care than any other nation.”

The Solution

Americans are being prescribed, taking and spending more money on medications than ever before. Staggering fact for the day: More than 10 percent of Americans (and more than one-third of those 60 and older) used five or more prescription medications in the past month, according to this 2008 CDC/NHCS survey.

Note to self: It’s not working.

Our “one ill-one pill” solution is expensive, ineffective and (in an increasing number of cases) unsafe. We need a new approach. I’m proposing a new solution, one that is more affordable, accessible, effective and safe for the chronic health conditions I see in practice every day — conditions that in most cases are caused or exacerbated by stress. It’s a solution that is truly preventive rather than reactive, one that creates health and wellness. It’s participatory and collaborative. I’m calling it “Rx Life.”

The Rx Life Solution:

1. Rx Food

Eat real food, not a long list of processed ingredients mashed together masquerading as food. Teach your children that food comes from the earth, not from a can. Grow and prepare your own food. Cultivate a garden or a farm. Buy and eat locally-grown, chemical-free food. Learn why Dr. Mark Hyman believes in the “power of the fork” and spread the word. Teach your kids that eating is a mindful process, not only about ingesting calories but also about nourishing your body, mind and soul. Eating is and ought to be a community activity.

2. Rx Activity

Move your body. Start with something — any amount, as much as you are able, and build on that foundation. Get your heart rate moving and see what it feels like to be so active that even your hair sweats. Get outside. Experience what author Richard Louv calls the “transformative power of the natural world” and refuse to let your children suffer from nature deficit disorder. Support school recess and encourage free play in natural settings. Inspire creativity — dance and sing, draw and paint, make things with your own hands, and cultivate your children’s imagination.

3. Rx Rest

Make sleep a priority. Create opportunities for rest, especially for teens; they always need far more sleep than they get. Instill good sleep habits from the beginning. Create a quiet, calm place for restful activities. Take time to simply be. Unplug and recharge. Value downtime. Remind your kids — and yourself — that it’s OK to stop. Listen to Dr. Aviva Romm when she tells you to stop pushing, pushing, pushing… and just breathe.

4. Rx Mindfulness

Be here now. Pay attention to the process. Realize that the most important time is now, the most important person is the one you’re with and the most important thing to do is what are doing right here, right now (thank you, Jon Muth — oh yeah, take time to read stories to your kids like The Three Questions). Practice yoga and meditation — anything to cultivate what Elena Brower calls the “art of attention.” Accept that you will never make all the stress in the world disappear and help your children build their stress-coping toolboxes. Take time to look someone in the eyes, listen to her story, and let her know that you hear her. Be willing to sit in the mud until it settles and the water clears.

My promise to my patients and their families — and to my family and to myself — is to spend more time prescribing and living life, to honor the power of food, activity, rest and mindfulness to promote healing and prevent illness. I am fully and authentically committed to walking this walk. Will you join me?

August 2011 Kiwi Post: “Past, Present, Future”

Happy Birthday, KIWI!  You’re almost 5-years-old, ready to start grade school. As a pediatrician, I’m so used to thinking about age this way… what is five years actually in magazine years? I think it’s a very significant milestone, especially in this age of digital media. KIWI is relevant in 2011 because it speaks to the growing number of families interested in natural, healthy, “green” living. You’ve come a long way, KIWI, and I am proud to work with you. In many ways, my pediatric practice and family life have grown in parallel with you.

(click here to continue reading…)

February 2011 Kiwi post: “Fever Phobia”

Fever Phobia

Every winter I am reminded of the great “Fever Phobia” that plagues parents everywhere. In the Northeastern U.S., where I practice, we’re up to our necks in snow, ice and viruses. Cough and cold viruses, stomach viruses, and flu viruses—you name it, we’re seeing it. And the number one reason by far parents call us is—you guessed it—fever… (to read more, click on the link above)

New “The Whole Child” Post on the Kiwilog: January 2011

Ring in the New

New Year’s is in part about resolutions: wishes for the year to come. On everyone’s list is usually something about eating healthier, exercising more, and being less stressed. These are often cited as personal goals, but more importantly, they are core integrative principles that we can use to chart a course towards a healthier future for our children. In this month’s post, I wanted to profile three real-life examples of model programs that are helping families live healthier lives… (click link above to see more)

New “The Whole Child” Post on the KiwiLog – September, 2010

"Building the Mindfulness Toolbox" is now posted on the KiwiLog.

“Alternative Medicine” in the news… a bit too much?

"Alternative Medicine," a term I don't like very much, has been featured in numerous AP news reports this week, all by the same writer. Something's fishy.

[Read more…]

Bring it on

So here we are – 2008 fading, 2009 coming on fast.  There are many reasons to be cautious and fearful, but I am cautiously optimistic that we are on the brink of a new era.  An age in which children are recognized, supported and celebrated.  So whatever you are resolving to do (or to not do, as may be the case), remember the kids in 2009 and let's work together to make it a healthier and more peaceful year. 

Happy New Year to all.

Best,
Larry

Report from the AAP NCE

Each fall, the American Academy of Pediatrics holds its National Conference and Exhibition. What were the take-aways this year?

[Read more…]