Being a Survivor

This post is dedicated to Nettie and her children

When I was a very young person, pre med at Harvard, I started watching the television show Survivor. I remember being thrilled by the ability of humans to survive, and even thrive, under the worst of conditions. 

I had had a hard run as a kid and was inspired by others who made something of this life with little to start with.

Those that do thrive, find places inside of themselves to journey. When we relinquish the right to physical comfort, and accept that the answers are always inside of us, we transcend discomfort.

Survivor, as a show, illustrates this process. The players who do make it, transcend their bodies, grow their souls and elevate their capacity to tolerate physical pain, social isolation, fear, lack of sleep, lack of food.

I never owned a television but I watched the show faithfully for 12 years, on late night study breaks, my laptop perched on my knee, a CBS pop up, a fuzzy five inches by five inches, enough that I could track the triumphs and the losses of a group of humans, stranded in the wilderness, learning to fend for themselves and still build real and sustainable bonds. People challenged physically and psychologically, to not just survive. To thrive. 

To some extent, I saw my academic career the same way….by the time I reached fellowship, I was competing with the nations’ graduates for only 6 positions nationwide in integrative oncology, and only one in Philadelphia. 

I had to not give up, not ever, not for nothing. 

There were times where I slept in my car or in the library, there were times where I relied on others for meals, there were times where I was sick and there were times I failed. There were a lot of successes in my academic life but to make it, I made significant personal sacrifices. Throughout, there was a deep sense of loneliness in my ambition to be the best at what I do.

I haven’t watched the show in quite some time, but I had an accident last week and had to stay home. It was powerful for me to see how the show has continued to evolve and yet focus on the same message….there is, at all times, the possibility of transcending discomfort, sometimes it’s through the power of your will, and sometimes it’s because of those who walk with you.

If you can, go to CBS, Survivor, Season 40, and watch the first couple of episodes. They have brought back the season’s greatest players to battle each other. In Episode 4 of this season, they highlight Ethan, a boy that won Survivor when I was just a girl. Since then, he has battled cancer. It is a miraculous testament to the human spirit to see him play this episode. 

I cried as I watched this episode and I thought of all of you. Especially now, where although many of us are at home together, many more of us are isolated, and feeling very alone.

I thought…there will be times in all of our lives wherever we are on this journey where we think, “I can’t take one more step. I give up.” 

And part of our mission as a team to do is to have the conviction to look straight in your face and say, “Don’t give up. Not ever. Not for nothing.” 

Even if you are moving towards your last breath, it is your will to survive that those you leave behind remember, and it is your fight that is the enduring testimony of your love. And for many of us, for most of us, miracles will and do happen. 

And we will not just survive, we will thrive. 

Dr. Roy

Update on Safety Protocols and Health

Folks,

We know many of you are frightened. We want to make sure we continue to update you with the intent of educating and preparing you.

Fear, when it is indulged, distracts us from life itself, from being in this moment, from loving each other, from living out our purpose on this earth.

This is a moment in time. It will not last forever. As uncomfortable as it may be, it does present us with opportunities for growth…look for these.

IF YOU READ NO FURTHER, READ THIS:
Your Number One job if you are in treatment or two years out from treatment; have diabetes, heart disease or lung disease (which includes asthma and emphysema), is to AVOID getting sick.

There is only one sure fire way to do this.
—DO NOT touch your face
—AVOID people who may unpredictably cough in your direction.

WHEN DO I CALL?
If you are trying to reach Dr. Roy or Dr. March and you do not have access to a computer, you call (248) 798-2942

WHEN DO I TEXT?
If you have a CLINICAL emergency, you text (248) 260-8866
Use the words “911: your name: symptoms”

WHEN DO I EMAIL?
If you have ANY issue or question that is not a clinical emergency,
you email dr.roy@aimnatural.com

PREVENTION:
—It’s important to wash your hands. Why? Because you can’t help touching your face

—You MUST wash your hands if you have walked outside of your home

—You can use hand sanitizer but it needs to be 60 percent alcohol

—If you are coughing or sneezing, you MUST cover your face with your armpit and wear a mask around others

—You MUST avoid crowds, this includes the grocery store. It’s been observed that people do not always avoid close contact in the stores, and it’s impossible to predict if someone will cough near you. You cannot know if the person who coughed is a carrier. So when you do have to go to the store, the gas station, or places like that, you MUST wear a mask. If you do not have one, it’s okay to tie a scarf around your face, and it’s helpful to wear glasses, if you have a pair

—This is NOT a time to travel by train, plane, bus or use share rides. IF you MUST, email dr.roy@aimnatural.com so Dr. Roy can prepare or supply you

—This virus lives on surfaces for 6 days or more.
So if on Sunday, someone coughs and covers their mouth with their hand, then picks up a box of mac and cheese and puts it back on the shelf; and then on Thursday you go to the same store and pick up that mac and cheese and take the box home, you are taking the virus with you. If you put in the cabinet and your loved one grabs it to make the mac and cheese, and rubs their eyes, without washing their hands, they have delivered the virus.

—In our clinic, our current recommendation is to disinfect any object or surface you bring home. Bleach, Ammonia or Soap and Water is fine.

—It’s helpful to wear gloves in public so you can be cued in to avoid touching your face

WHAT DO I NEED TO DO TO IF I HAVE OR HAD CANCER, DIABETES, HEART DISEASE OR AN AUTOIMMUNE ILLNESS?
Please note, part of the reason why we are encouraging our patients to contact us for a 15 min phone call to protect and preserve their health is access to medications, supplements, surgery, surgical procedures and surveillance is and will continue to NARROW.

Email us at dr.roy@aimnatural.com
Go to aimnatural.com and click on “Contact Us”

We can reliably predict at this time that we will see a peak in the impact on the health care system in mid to late May…and it may take months after that to recover services. Do not expect things to return to our new “normal” until early Fall 2020.

Examples of patients who are being seen by Drs. Roy and March at this time:
1. Patients who cannot see their primary care doctor and need support with primary care
issues.
2. Patients who are not as closely surveilled in survivorship and may be taking or have taken
drugs that are hard on the kidneys and heart.
3. Patients who are newly diagnosed and are not able to get surgery at this time because they are not emergent cases and need “alternatives” to standard of care.
4. ALL patients who are IN treatment, 2 years into survivorship or post-surgical, to evaluate and tailor risk precautions.
5. Patients who are being seen to lower risk of recurrence and need lab evaluation. We have access to safe labs for our patients only.
6. Patients with diabetes, heart disease and autoimmune illnesses NO EXCEPTIONS.
7. Patients with symptoms of CoVid or cold or flu that need home management.
8. Triage for families in crisis.

Please do NOT cancel your appointment with Dr. Roy or Dr. March without talking to us first.
There is the impression among our population that for those of you in long term survivorship, you can wait. That may be the case, it may not be. We may want you to move a surgical procedure up, or ask you to stockpile a certain medication.

We will let you know if you can defer labs or care, how to get care safely, how long you can wait and what to anticipate.

Another major issue is access to supplements. We have permanent shortages now in immunomodulators like mushrooms and in antioxidants like elderberry.

Some of our patients are seeing delays of 2 weeks out of manufacture and distribution, even when they placed an order in early March. This may get worse. Even more importantly, some of the supplements we RELY on for keeping our patients in survivorship, well are no longer available.

We cannot stress this more urgently, we need to guard against shortages for our patients, and at this point, come up with alternatives. These have to be an individual consults. For these, do NOT text Dr. Roy, email us instead at dr.roy@aimnatural.com.

HOW DO I KEEP MY HOME SAFE?
1. Do not allow visitors. This includes family, friends, neighbors, grown children who are checking on you, etc.
2. Clean and disinfect high-touch surfaces daily in household common areas (e.g. tables, hard-backed chairs, doorknobs, light switches, phones, tablets, touch screens, remote controls, keyboards, handles, desks, toilets, sinks)
3. You can use 4 teaspoons bleach per quart of water, hydrogen peroxide, alcohol wipes, ammonia or soap and water.

WHAT DO I DO IF A PERSON IN MY HOME IS SICK?
1. FIRST OFF, the person who is sick should be isolated from the rest of the household immediately. If possible, they should have their own room and their own bathroom with doors that close.
2. Assume that it IS CoVid if they have a dry cough, fever and shortness of breath.
3. If they have tummy stuff and their mucus is green or brown or bloody, or they have a wet cough, it could be something else.
a. Either way, if a person in your home has symptoms, you must TEXT Dr. Roy at (248)260-8866: “911: your name: your symptoms.”
b. Do NOT go to the Emergency Room or Urgent Care unless your loved one is having shortness of breath that cannot be controlled with at home care like inhalers. Be prepared that once you take them to the hospital, you will not be able to stay with them.
c. Do NOT try to get tested, it’s not appropriate as there is no cure.
d. Please try to have access to a thermometer, a pulse oximeter, Tylenol and sugar and salt water like Gatorade or popsicles. That’s all we should need for many of you.
e. First contact Dr. Roy and we will start with managing you at home and have a nurse evaluate your symptoms.
f. You can also contact Emcura.com and create a patient profile. A nurse will call you to evaluate you over the phone.
g. Another option is to try to reach your primary care doctor for advice.
4. When you contact Dr. Roy, we will send you detailed instructions on the procedure to manage your family member or friend and protect the rest of the household.

FOR OPTIMAL LUNG HEALTH FOR OUR PATIENTS WITH COPD OVER THE SUMMER 2020*

In addition to the guidance given by the CDC for prevention of CoVID-19:

1. Take 500 mg of Vitamin C three times a day
2. Take 10,000 IU of Vitamin D with food daily (if you have symptoms, stop this)
3. Take your steroid inhaler every morning and night.
4. Take your Singulair, if prescribed, every night.
5. Take Claritin twice daily.
6. Run an air filter in your home while you are sleeping
7. Keep the windows open only if you have access to clean, fresh, air.
8. Wash your sheets and pillowcases with organic, dye and fragrance free detergent
9. If you have a nebulizer, do a breathing treatment as needed and make sure the parts are well cleaned and sterile
10. Do a neti pot every morning with saline
11. Steam over a cup of hot water with eucalyptus essential oil, 5 drops, then add a tea bag of cold and flu tea to the water like Traditional Medicinal “Breathe Easy”, let it steep for 10 minutes and drink the tea with the eucalyptus. Any mint tea will do.
12. Get in the habit of doing breathing exercises daily. There are many techniques, but one that is wonderful is called 4 square. Spend 4 minutes in the morning and at night doing the following:
a. Inhale through your nose for a count of 4
b. Hold for a count of 4
c. Exhale through your mouth for a count of 4
d. Hold for a count of 4
13. Take 1000-2000 mg of Quercetin daily
14. Take 1000 mg of fish oil with food, daily. It should only be from Pure Encaps, Nordic Naturals or Carlsens
15. Eat dark colored berries or dark leafy greens, four handfuls a day
16. Take something for anxiety like Theanine at bedtime, 200-400 mg is fine
This is a respiratory illness, so GUARD your LUNGS.

WHY ARE THE NUMBERS RISING IN MICHIGAN?
They are not rising all over Michigan. The hospitals in Grand Rapids, for example have room still.

They are rising in urban areas where we have a larger population of people who may be under or not appropriately educated about the virus and not practicing social distancing.

To some, who have never had time off of work or a “vacation”, this can present opportunities for joy, and social gathering that is unprecedented. For others, losing their job and valuable income has forced them to live in groups or rely more closely on others, which puts them into proximity to others.

Also, in places like Sterling Heights, Canton, Dearborn and Detroit, many homes host large numbers of family members who depend on community contact to get by. Childcare is often the job of aunties, neighbors, grandmothers, and people go to each other for food, comfort and news. Visitation with children who don’t live with the visiting parent is still happening and this puts elders and vulnerable populations at risk. If one person doesn’t have dinner, their neighbor will have it for them. Social distancing presents a significant cultural challenge as it is antithetical to survival for many.

There are large assisted living and to some extent, unregulated, home care businesses and home care workers throughout the state, and high numbers of Michiganders with obesity and smoking related illnesses like COPD, cancer, diabetes and heart disease.

Please remember, just because it’s our birthday or it’s another historic event in our personal lives, just because you miss your kid, just because someone has news, does NOT mean we can have people come by, even to pick up food or have a piece of cake. Hold tight. This will pass.
For now, any contact right now, with people outside of your home, is dangerous.

HOW DO I PROTECT MY MENTAL HEALTH AT THIS TIME?
—Turn off the television, radio and social media and STOP checking in on this virus. It’s not checking for you. The news is unfortunately, a terrible source of information right now.

—For actual information, go to the CDC and the CDC alone.

—Call Jessica 269 808 6422 at or Michael at 248-390-3864

o They are both trained in crisis and will speak with you for as little or as long as you would like, to help you talk through your anxiety, sleep issues, coping mechanisms or family issues that are coming up with coping.

o We are waiving co pays for April and May and all consults will be covered under insurance so there is NO cost to talk to a counselor.

—GO OUTDOORS and EXERCISE. Exercise is fundamental to your mental health and will help you from feeling cooped up and caged in. Keep a 6-8 foot distance from others.

—Eat healthier. It may be counterintuitive, but maintaining a healthy weight and eating nutritious food is one of your most powerful weapons in managing your mental health.

—Get creative: paint, take photos, collect botanical specimens, draw, sew, write, read, do yoga, dance, make crafts, do puzzles, play games. This time will really challenge you, especially those of you with kids at home. Doing these kinds of things will keep you out of your head and in your heart.

—Journal, punch a pillow, shadow box, put on headphones and dance like an idiot. Put on headphones and ignore your family.

—Take baths, use lavender essential oil, Epsom salts, eucalyptus.

—Try to watch or engage with things that make you laugh.

—Those of you on mental wellness medications like antidepressants, sleep aids and anxiolytics, MUST take supplements to partner with those drugs and make them work better while lowering the side effects.

And when in doubt, go to bed. There is almost nothing that a good long sleep won’t help.

Dr. Roy and Dr. March

*This is not a substitute for social distancing, shelter at home, hand washing and personal protection equipment, nor does it prevent CoVID-19. It is a robust foundation for prevention of pulmonary events.

Staying Connected

For those of you that need support with:

• Television, speaker, apple products at home

• Making it possible for you to speak to your family members or coworkers from your computer and continue to function as usual

• Transitioning a small business to online consults

• Setting up iPads for elderly folks who need games and the ability to communicate

• Setting up electronic delivery systems for people who are homebound.

• Apple or internet connection issues

• Syncing your devices

• Using your iPhone

• Setting up online systems for your kids to study, stay entertained and stay safe while gaming at home

• Setting up your devices or working with a device that is not working well

• Using your devices for increased entertainment and virtual sharing with neighbors

• Creating virtual, live support groups, worship or chat forums

• Anything IT or MAC related

Please TEXT (586) 604-2808

Kyle is our IT person and he has been moved entirely off-site. He is available any day of the week for these kinds of issues. He can remote in or come out to your home or office. He has protective gear and has been isolated from the clinic for 3 weeks. He has no multi-exposure.

Most importantly, he has been with us since the first day we opened our doors to practice, he is trained in confidentiality and is someone you can trust to connect you and your family to others at this time.

TEXT Kyle at 586 604 2808 to Get connected and Stay connected.

Drs. Roy and March

Immune System Support

Dear Patients,

The situation seems to be getting worse before it gets better. And in no small part because of the nationwide shortages in everything from supplements to antibiotics.

Please do not hesitate to schedule 15 min to check-in and make sure we are adjusting your plan to reflect that data. You can do that at dr.roy@aimnatural.com

*******

When things get challenging we MUST go back to the basics and trust the wisdom of our ancestors. 

While it may be the only tool we have, it’s also, even in crisis, the most powerful.

As a matter of lifestyle, consider the following:

• Be out in nature OR stay home as much as you can. Try to avoid going anywhere else unless you have to.

• Wash your hands frequently, especially before eating and touching your face. Wash for 30 seconds with soap and water.

• But wait….Do not touch your face. Really. 

Stop here. If you JUST do the first three, you will not get a virus. 

• Start to really check-in and listen to your body. Stay home if you simply feel “off”.  Even if you do not have a cough, fever or shortness of breath. 

• Cover your cough with your elbow and teach your children to do the same

• Don’t hoard, and ration what you have…think about letting all those groceries and supplies get you through a whole year. Teach your children to ration as well. We over-consume as a culture, let’s try to minimize the pressure we are putting on our pocketbooks and our suppliers to meet our demand. 

Stop here. If you did these next two, NICE job. You are protecting others AND the economy.

• In the morning and at night, after brushing your teeth, unless you have had a head or neck cancer or a history of alcoholism, use Listerine, Dental Herb Company’s Under the Gums Irrigant, or in a pinch, coconut oil with 10 drops of eucalyptus and lavender essential oil, and swish for 120 seconds minimum. The essential oils have potent antiviral activity, including against the flu and other viruses that have an ‘envelope’ around them. 

• Use a Nasal irrigant in the shower. It can be a neti pot like Neil Med or just a clean mug with a little bit of salt and hot water. Make sure you sterilize it after use. Viruses love the mucus membranes in the nose and attempt to colonize there for days before they make their way through the respiratory tract.

• In the shower, when you are done bathing, turn the water as hot as you can and run it until you really can’t take any more heat, quickly turn it all the way cold for 30 seconds and then back to hot. Repeat this three times.

• Play a guided visualization at bedtime. I like Healthy Immune System from HealthJourneys.com

Again, Stop. If you have gotten this far, you have done a ton of work on prevention and have used ancient Indian techniques to do so….go you.

• Eat lots of fruits and vegetables, more than you eat anything else. If you are worried about keeping fresh veg in the fridge, freeze and blend into soups and smoothies. Talk to Dr. March about recipes.

• Drink half your body weight in ounces water with a little bit of electrolyte in it daily. The best way to get it in is to drink 5 big glasses first thing in the morning of room temperature water. It won’t feel easy, but you will start to notice a definite change in the quality of your day.

• Healthy blood sugar is critical to fighting infection. AVOID processed sugars, junk food, and pop. Your immune system takes a hit within 30 minutes of eating refined sugars.

• Take a brisk walk outside, be careful of falls, 30-50 minutes every day. Bundle up and listen, if you can, to music that inspires you.

• Be mindful that emotional stress results in direct physiological stress. It causes our sugar to rise, it raises our inflammation levels and it handicaps our immune systems.

• The most important piece of all is sleep. Sleep for 8-9 hours a night, is the foundation of our emotional and physical health. Without it, our immune system is unable to fight off infection.

Don’t stop now! Nothing can stop you now. Here’s where we start to lose weight, reverse disease and improve long term outcomes!

Laugh freely and often with those you love. On the phone or 6 feet away from them….of course.

A “quarantine” doesn’t mean we have to sit around getting chubby, worrying about money, relying on old Survivor re-runs….wondering if you dare eat that last bag of chips.

It can be, instead, a time for quiet, self-reflection, a reset, a hiatus, and a way to finally invest in you.

When has the world ever asked of you to stay home, sleep and play outside?

Supplement Orders Update

Dear Patients:

I am and continue to be concerned by the trend to buy up as many of everything as people can as it impacts our patient population. Many doctors and clinics have been purchasing supplements and partially capitalizing on this panic. 

There is NO cure for ANY virus, your immune system will do its job and take care of it. Supplements can support your immune system but they will NOT prevent the spread of the virus as we think now that it may survive on surfaces for perhaps days. The result is that the major distributors of therapeutic pharmaceutical supplements are not able to keep up with the demand. 

Supplements aren’t like bleach, they cannot always be manufactured, and sometimes they are harvested or grown. 

There will be delays in receiving supplements necessary to your care.

Our biggest concern is our patients who are not able to get treatment, in chemoradiation and or in their first 2 years of survivorship.

Our response has been to take a loan against our staff salary budget and buy 20-30 bottles of available stock so that we have some sort of safety net for you and also don’t deplete the stock available to other cancer practices. 

They should be here by Saturday, March 21st. 

We will have in the office:

• Melatonin 20 mg

• Reishi 

• Vital 10 probiotics

• Glutamine

• Magnesium Glycinate

• Ginger Root

• Ashwaganda

• Vitamin D

• B12

We will make that stock available to all our patients but we are prioritizing cancer patients.

You can and should still order through bewellwithaim.com 

You may find though, that you place an order and are told the item you needed was out of stock. 

In that case, you will be told if we have it in the office or if we can replace it with an alternative. 

If we have it, you will need to show up during office hours and pick up what you need, as we cannot ship to you unless you are out of state. We are continuing to follow precautions and our office is a safe place for you to stop by.

If we do not have it, you and I will wait until it becomes available again.

It would behoove our patients who are IN treatment to try to get and store 3 months supply of supplements now in case there is a permanent shortage.

I am so sorry that we didn’t predict this and buy in bulk earlier, it wasn’t part of our business model and it is absolutely something I should have anticipated. I truly expected restraint from my colleagues. 

For those of you who do not have cancer, and are not in treatment, or are outside of your 2-year survivorship window, still place your orders on bewellwithaim.com but please be patient with us as we prioritize needs.

As usual, do not purchase supplements over the counter without running it by us. It may be safe or it may indeed make things worse.

Thank you. 

Be well,

Drs. Roy and March

(248)798-2942
dr.roy@aimnatural.com

Covid-19 Update

Dear Friends,

Please do not be alarmed by the news. Nothing new has been discovered about viruses in general. They are just trying to really nail down three things:

1. How is it most effectively transferred from person to person?

2. How can we quickly create infrastructure to manage higher traffic of people at health care centers who show up with cold or flu symptoms?

3. How can we have effectively tell which people who show up with symptoms have this virus versus another?

What is a virus?

Viruses are not living creatures. They are a plasma capsule carrying a fragment of genetic material. They cannot survive for a long time on their own. Without a host, they dry up and die.

Think of them as a partial blueprint for how to make themselves suspended in clear jelly.

If a person touches a surface where that virus (tiny fragment of DNA suspended in a jelly) is sitting, and then touches their nose, eyes, ears or mouth, they can deliver that little fragment to their nasal passages and lungs.

That little fragment enters one of your cells and tacks its blueprint onto yours.

Every time you make things you need for your own cells and you print out copies of your blueprint, you also print out copies of the virus’s blueprint. 
The thing to remember here is that this is ALWAYS happening, every day that you live on this earth.

We live in a world that is crowded with critters not visible to the naked eye. There are more bacteria, viruses, fungi, parasites in your own body than your own cells—some are critical to your survival.

How do we survive in this invisible microbiome? We have a really sophisticated and well developed immune system that is designed to notice critters of every kind and to knock them out.

If you are immunocompromised, this means that your immune system is not at its best, but it does NOT mean you will get the virus and get sick.

It means compared to someone who is not immunocompromised, if both of you run your hand on a doorknob and pick your noses, you are more likely to have cold symptoms.

If you do get “sick”, that does not mean you will get very sick. Even if you are immunocompromised, it's still true that over 80 percent of people do not get very sick and instead just have mild respiratory symptoms that resemble a cold.

Also, typically, even if you are weaker, your immune system will take care of it, it just takes longer. Antibiotics won’t help and can make things worse. 

Immuno supportive supplements can help but nothing can replace sleep, lots of green leafy veg and bright colored fruits, meditation, yoga, prayer...and a little bit of cardiovascular exercise to strengthen your immune system.

Here’s what we do know about this strain:

ϖ The only difference between this virus and its cousins is it can last longer on surfaces. So if someone coughs, sneezes etc, on a table, that little jelly thing can live there for maybe even one day.

ϖ There is still NO change from what I’ve told you before about transmission. You CANNOT get a virus by living in the world.

ϖ There are only two ways to get a virus:

1. To be coughed or sneezed on by someone who is less than 6 feet from you so that respiratory droplets land directly in your nose, eyes, mouth.

   OR

2. To touch a surface that has been coughed or sneezed on and then touch your face.

An example would be if the person who has a virus coughs in their hand and touches a door knob and you touch the same doorknob let’s say 20 min later and then touch your face. 

But just because you are exposed, (see above) does not mean you will get sick.

General precautions for generally healthy people:

♣Do NOT touch your face

♣Wash your hands in case you forget and do touch your face

♣Wipe down high touch surfaces with a bleach containing solution

♣Do not let your kids or elderly family members hang out in crowds where people are coughing

♣Teach your family to cough into their armpit

Precautions for our Vulnerable Patients:

If you are worried or unsure if you are vulnerable, I expect you to schedule a 15 min phone conversation with me or Dr. March at (248) 798-2942 or mailto:dr.roy@aimnatural.com to learn if you are at risk or need to take specific precautions. 

Please know, if you haven’t gotten bloodwork done in three months, we will need to draw blood before we speak to you. If you have blood work, I still may do a repeat CBC.

At AIM we are defining our vulnerable patients as:

ϖOver 75

ϖAnyone with COPD (asthma, chronic bronchitis or emphysema)

ϖAnyone getting chemotherapy, radiation or targeted therapy (not hormonal therapy)

ϖAnyone who had surgery (not reconstruction) within the last three weeks.

ϖAnyone currently fighting leukemia, lymphoma

ϖAnyone with an absolute lymphocyte count under 1.0

ϖAnyone with a total WBC count of under 2.5

If you are in this group, I’d like you to limit unnecessary interactions and stay home for the next 3 weeks, like a self quarantine. 

If you are in this group, I’m advising a travel restriction for 6 weeks unless it’s absolutely essential. 

15 min phone conversations are an opportunity for you to ask specific questions about your situation and also to MODIFY the self-quarantine. 

You are each unique individuals in unique situations, the quarantine can be modified for your circumstances; however, please do not modify without speaking with one of us. 

The Office Environment:

You do NOT need to come in if you are opposed to doing so, but for those of you that fall under “General Precautions,” it is safe to do so. 

If you are scheduled with us, barring medical emergency, you do need to keep your appointment.

We have to ask for your patience. As we move many patients onto tele conference, there may be delays in when we get to you. Similar to longer than usual wait times in the waiting room, we will still expect that even if we are running late to get to you, you will be available to talk. 

We have implemented protective measures for you and our staff. These include:

1. Daily meetings with oncology at three large hospital complexes in the region to make sure that our safety protocols are consistent with theirs.

2. Daily internal meetings with our clinical staff to discuss emerging data.

3. Our offices are cleaned with hospital grade cleaning products, especially our “high-touch” surfaces, multiple times a day.

4. We are running filters that do clean the air of airborne particulate, including viruses and will filter every square inch of our two clinical spaces while you are in office to prevent any airborne transmission (which at this time, is not necessary).

5. We have a new “no touch” policy to avoid skin-to-skin contact where we will not shake hands, fist bump, or do physical exams that involve skin-to-skin contact.

6. We will contact you before your appointment to move you to phone or Zoom instead of having you come into the office to avoid you coming in unnecessarily.

7. The admin and front desk, who really carry the brunt of all of the grind associated with these changes are critical personnel for us. We cannot serve you if Kyle, Emily, Sydney and Diana are not well. For that reason, all front desk persons will be wearing a mask and/or gloves while in office to protect them from multiple patient contacts.

8. We clean the offices at night and the morning before clinic DAILY with hospital grade antimicrobial products.

9. All of our clinical equipment is sterilized after each patient use.

10. ALL clinicians wash their hands before and after each patient contact, including mental health.

11. We have fliers posted on the building and on our door advising patients on what to do if they have a cough or cold symptoms.

What do you need to do to protect us so we can continue to serve you?

Please only bring a family member with you into the clinic if they are necessary for you to walk, hear or process information. Otherwise, to keep traffic low flow, only patients who are well enough to be in office and need to be seen in office will be in the clinic for the next three weeks.

Please do NOT come to the office if you have been in contact with someone who has cold or flu symptoms, has tested positive for, or is suspected to have, TB, Hepatitis, (Herpes Zoster) Shingles, Chicken Pox; or if you yourself have cold symptoms or a dry cough.

Please call us from your car and we will escort you from the parking lot, and will help you get to the office safely.

Do show up for your appointments, even if they are on the phone or zoom and be seated and at home. We will not talk to patients if they are in a public place or in transit and you will be charged for the time.

I want to close by saying the following: First, we will continue to keep you posted. I realize that you may be afraid. Don’t be. We are committed to keeping you safe, and we really will be okay, as a community and as a society.

Second, you really only have one gold star weapon against a virus: Don’t touch your face. 

Third, as people are unable to gather in large groups at community centers, churches, support centers, addiction groups, concerts, and so on, people will start to feel isolated. Please use this as an opportunity to demonstrate that love is greater than fear. 

Fourth, this can be an opportunity to allow our character to shine. 

Do not forget your neighbors, reach out to the elderly people in your building. Continue with support groups over the phone. Small groups meeting at homes are safe. Model for your homebound children civic action. Public schools were providing meals for kids from poorer families, reach out to those who may need a hand. Just don’t shake hands!  

Do not buy every roll of toilet paper on the shelves, leave a roll for someone else. Frankly toilet paper has no real purpose in this crisis. Do NOT buy surgical masks or medical supplies. That action is one of the reasons why we are ending up with this quarantine, it puts medical staff at risk as there aren’t supplies left. Because our doctors and support staff have high volume exposure to sick people, they can be unable to work or worse, become a vector to spread disease. 

Try to reinvest in ways of communing with each other and your kids that we have gotten away from. Don’t go to play centers, malls and movie theaters with them, read, write, paint, play outside. Recognize that as caregivers of grade school kids have to make adjustments, people are trying to communicate remotely, and our healthcare workers are slammed and under resourced, we all need to be a little more patient and forgiving of each other. 

Accept that there is some financial loss associated with these changes and that will change, treat it as a time to slow down, recognize the long game and take good care of yourself. 

The government’s reaction to this crisis has nothing to do with any one of us getting a respiratory infection. It has to do with the lack of supplies and infrastructure necessary to manage high traffic flus and pneumonias. The quarantine is to lower the burden on the system as much as it is to protect you. So don’t worry, you still have a life to live. Email us at mailto:dr.roy@aimnatural.com or call (248) 798-2942 to modify precautions. 

This will pass. 

Be well and with love,

Drs. Roy and March

Coronavirus

Dear Patients:

Our patients are worried, as many others are, about the “Coronavirus”. I would like to reassure you by getting you properly educated.

1. If you are worried about your immune health with regards to the virus, it is important to make a 15 min appointment with us (we can do these over the phone), to protect yourself. If you have kids and you are worried about them, it is important to talk to Dr. March.

2. If you are getting chemotherapy or are immune suppressed, particularly if your lymphocytes under 1.0, please call the office at (248) 798-2942 and make an appointment so we can preserve your viral immunity. Each of you is wonderfully unique; your situations are unique, and what works for you will not necessarily work for someone else.

3. The most important way to avoid contracting a virus is to avoid touching your face. This means: do not pick your nose, rub your eyes, or put your fingers near your mouth. To contract a virus it has to be delivered. The way to deliver a virus is to pick it up on your fingers and smoosh it into a mucus membrane. It is that simple.

4. The trend of stocking up on paper towels, toilet paper, hand sanitizer, and Clorox wipes is unnecessary. The only thing that can kill a virus on surfaces is a bleach solution, but you can use regular bleach with water—it doesn’t have to be a special wipe. We clean our offices every morning with bleach. We use it to sanitize all high touch surfaces: doorknobs, chairs, counters, keypads, etc. You may do the same at home.

5. The reason handwashing is so important is that no matter how much people try not to, they do tend to touch their faces. Wash your hands frequently with soap and do not touch your face.

6. If you are frequently in doctor’s offices or hospitals and you are getting chemotherapy, or if you are immune suppressed, you must wear a mask. If you are traveling and seated near someone who is coughing, you should wear a mask. As far as we know Coronavirus is spread through respiratory droplets from coughing. If someone is coughing in your general area it does not mean you will get sick. To catch the virus it has to get into a mucus membrane, which, unless someone is coughing right in your face and it lands in your eyes or nose, means you have to touch your face with the finger that someone coughed on. Gloves are more important for our immune-suppressed population than a mask (even your nice winter ones are fine), but you still should not touch your face without washing your hands.

7. Please do not buy masks in bulk. If you need one, visit your hematology oncology office. Supply companies that supply hospitals are running out and medical technicians do need these when working with respiratory populations or doing procedures. If your medical staff is at risk then we will see a spread of airborne illnesses that can handicap us.

8. Supplements cannot treat a virus alone, but they are important to support your immune system and are entirely individualized. You must talk to Dr. Roy or Dr. March about what to take and you will likely need an adjustment to your supplement plan.

Coronaviruses are not new. They are an umbrella term for a bunch of respiratory viruses that can cause pneumonia. This is simply a new strain of these viruses and our immune systems are usually well equipped to manage them. Symptoms are cough, shortness of breath, and fever. They do not include stomach distress. In 81 percent of cases, symptoms are mild and there is no resulting pneumonia.

I am not sure why there is a media frenzy around this topic, but from my time in journalism I know, “if it bleeds, it leads”, and there is a general sense among Americans of feeling unsafe. This sentiment is not only profitable for companies that generate information but also seems to feed on itself and create widespread anxiety.

Our patient population at Associates of Integrative Medicine is vulnerable, but this is true of pneumonia in general. Even if our viral immunity is not perfect, we usually will not have as serious consequences from viral pneumonia as we do bacterial pneumonia. 

I do not want you to be afraid. I do want you to reach out and I do want you to be protected in the right way. Remember, the foundations of health are the foundations of a strong immune system: 8-9 hours of sleep a night in a dark room; eating lots of well-washed fruits and vegetables; getting at least 30 min of exercise daily; focusing on our mental health, and remember what you learned in grade school….don’t pick your nose.

I will update you with new information as we get it. We do get minute-by-minute updates. Until then, if you are getting treatment or are in the first couple of years of survivorship, or if you are just worried, I expect you to make a 15 min appointment by phone so we can help you to be well and stay well. 

With love,

Dr. Roy

What Does it Mean to be a Woman in Survivorship?

Nayana, a black girl with a swan-like neck and startling cheekbones is far too young for three years with metastatic lung. She looks at the ground and blinks twice.“I miss my eyelashes. Without them, I don’t feel quite….human,” she states.

Sarai,an older lady with a terrific will and metastatic breast, breaks down for the first time in the three years I have been treating her. Her voice soggy and bleak, she cries, “They took my breast and I gained all this weight in my stomach. I don’t feel like a woman anymore.”

Danae, a glossy manicured blond and mother of five young children, presents following bilateral mastectomy with reconstruction, “I can’t even look at them in a mirror, I feel betrayed by my body. I don’t even look at my husband’s face when we have sex.”

Irai, a Jewish nomad, writer and farmer, presents with suicidal thoughts following port placement. “My skin just sits all wrong, this thing makes me nauseous, it skeeves me out…like I am an alien or a robot. I can’t do this anymore.”

Laila, 42, newly married, with a recent diagnosis of BRCA positive ovarian cancer, following surgical debulking and bilateral mastectomy, looks straight ahead and cools the room with her quiet words, “I feel like I have failed him…what kind of wife can I be? It hurts to have sex, I have lost my hair, my breasts, I just don’t know what I can give him anymore.”

All of these women are survivors.

We run a survivorship clinic. Our work is to partner with our patients and their team to:

1. Protect our patients from acute and late term effects from treatment

2. Lower risk of recurrence and progression with cancer

3. Empower our patients to use Food and Natural Therapies to fight cancer

4. Support our patients in feeling optimally well.

But, when we talk about survivorship, from the first day of diagnosis through the balance of a person’s life, there are certain topics that just don’t get much play in oncology.

One of these is what we looklike when treatment is all said and done.

Part of why this conversation is so hard is it begs the question, What does it mean to be a woman?

From the time we are young, we are indoctrinated with a belief that:

What makes us beautiful, makes us female.

And

What makes us female, makes us worthy.

So when we are asked "What does it mean to be a woman?" for many of us, what we hear is, What Does it Mean to be Beautiful?

The answer has become, universally: youthfulness, long hair, long eyelashes, thick brows, radiant skin, symmetrical breasts, a small waist, white teeth, pretty nails. Someone to call me a wife, mother, daughter, sister.

And because these things, all at once, are difficult to sustain, they have become rings that we reach for, perpetually justout of reach.

A multibillion dollar industry gets fatter on our core belief by leveraging our need to feel worthy. That the standards are skittish and mercurial keeps the beauty business, IN business. I mean, big bottoms are in, then they are too too. Skin the color of baby powder is the height of fine and then the deepest bronze is deck. Windblown blond curls are on fleek, then Kardashian black, takes center stage. Thin and bony, is loish and in the same five-year period, a sinewy, masculine build makes the grade.

It can be a challenge for anywoman, as she moves through her life cycle.

But what of the Survivor?

When one is diagnosed with cancer, the shock catapults us into a fight for our lives. Quickly, almost gratefully, we accept “necessary losses”: our breasts, our nails, our hair, our uteruses…

We are expected to feel thankful to simply be alive, but when all is said and done and we look in the mirror, we are left feeling alone and bewildered as we seek to redefine our essential worth and choose to Live.

The American Cancer Societyhas been trying to start the conversation with its Look Good Feel Betterprogram.  This program partners thousands of beauty professionals with patients to teach them how to manage the appearance-related side effects of cancer treatment. The goal is to give women (and men), a way to feel normal, when “normal” no longer exists.

Margot European Day Spa, in Birmingham is looking to join this movement by bringing on aestheticians and massage therapists trained in treating survivors. The owner and founder of the salon, Margot Kohler, and salon director, Ursula Froehlich, have a personal commitment to making women feel beautiful from the inside out, regardless of their circumstance.

Kristina Juhas, with Eyedolize, also in Birmingham, is the first lash and brow specialist in SE Michigan to consult with survivors.

This is wonderful, and….there is still much more we need to do to truly meet the needs of any person who faces disability, loss, death.

Early last Spring, I was forced to consider a personaldiagnosis with a poor prognosis. 

I knew I would be offered surgery, chemotherapy and radiation. My body would become a testament to the deformity associated with diagnosis; no chance, short of Divine intercession, at cure.

I have failed to meet most of the standards society sets for being a “woman”.

I am not a wife. I am not a mother. I am complement in a male dominated field that requires a compromise in my emotional landscape. I am a business owner and a single earner. I am held to a level of professional conduct that rejects creativity and intuition. I am getting older and beginning to think about the changes I will face hormonally and metabolically.

I have lost one, and stand to lose, within the year, two more, of the only people that call me daughter

As a consequence, quite privately, I have cherished my “beauty.” I love my breasts and the color and texture of my skin. I have what we call in my communities of origin, “good hair.” (long and it does what I tell it to do) I have a nice figure, strong nails and bones, and I haven’t yet had to think about whether I am ready to give up my fertility.

As a patient, however, I had to consider my own “necessary losses”. Following a period of grief, I came to a quick acceptance for I am a person of faith and I believe that we are not our bodies, we are our souls. 

But truthfully, I wasn’t tested, because I thought I was going to die. One can face almost anything when death is imminent. The true test of my faith is Can I livefrom my Soul?

Living, I would have wanted my breasts, my lashes, my hair…All of It! And at the very least, I would want to know that beauty professionals who care about how to make me feel beautiful, exist.

I was cleared of the diagnosis of cancer, but I realized that to live with the anticipated losses would have forced me to redefine what made me a woman.

So began a conversation with myself about what makes me beautiful outside of my appearance and what others think of me. This has brought me into a fuller, more grounded version of myself.

I invite you to have the same conversation with yourself. It is entirely personal, individual and intimately yours…because what you decide makes you beautiful, simply has to be, just that…..yours.

I can tell you, what I see now:

For Nayana, it is her willingnessto be stand in the breach between living and dying and choose hope, her ability to stay in grace, all teeth in her smile, that makes her beautiful to me.

ForSarai,it’s that inspiredby the challenges that her grown son faces with gambling, she has begun a spiritualjourney to understand addiction, her commitmentto personal responsibilitya beacon for her family.

For Danae, it’s her devotionto her children, despite the fact that being a mother doesn’t come naturally to her...the drive to give everything she has, unselfishly, and quite consciously.

For Irai,it’s that she has opted out of surveillance and is living on a farm in Israel, where she runs through fields every morning until her lungs give out, her choice to be the revolution, to live outsideof the parameters that we as oncology professionals have set for her.

For Laila, it’s that she tells her story of what it means to be a wife in front of a room full of male medical students, one of whom may be quietly moved to be a better doctor, a better husband, a better son.  She is a livingtestament, her story, a prophecy.

A new definition, new words: willingness, grace, outsider, drive, personal responsibility...What I have come to understand is We are born female, but we become women.