and good evening.

>> Thanks so much for watching HealthLine on PBS Fort Wayne.

I'm your host Mark Evans have been since 2008 seven.

Can you believe that a lot of years have flown by I've learned so much and I get to talk to some great guests like the one we have tonight Dr. Rebecca Menza who is an integrative medicine special.

>> It's nice to have you here.

Thank you, ma'am.

And we're going to be talking about self care.

I don't think we've ever had that title for that subject on this program but self care kind of pops up here and there you hear a little bit more about and this doctor knows a lot about it.

>> She helps a lot of people.

So again, thank you for being here.

I know you have a busy schedule but self care you think is very, very important and that's what we're going to discuss this evening.

>> And can I ask why?

Because it is in integraive medicine we're really dealing with the what we call the four pillars of health are or the pillars of foundational pillars of lifestyle medicine and that is nutrition, exercise, sleep and stress management and all have control over in your life that you can make significant changes in your health .

But those all require self care.

Right?

They don't just happen without you making some effort and making some space for them in your life and life these days is so much more stressful.

>> It used to be very much so.

People are very stressed and they're they're time that that they have to do self care is less we are doing so much more for ourselves and where caregiving others and you know, it's a very stressful world and it's a very complex world and it's getting more so all the time.

>> Yeah, this is probably where the beginning I mean really there's going to be a lot more on the way.

So I think it's a good idea just to try to find out how we're going to handle that and level ourselves off so that we can function and maybe have more quality of life, definitely more quality of life.

>> Our phone lines are open for you right now two six zero and actually in this case 866- (969) 27 two zero.

>> Give us a call any time in the next half an hour we'll be more than happy to answer your question and it is a half hour show so it does fly by.

>> We don't stop down for commercials so get those questions in as soon as you can.

So Doctor, you mentioned the four attributes of self care nutrition, sleep, stress management and exercise.

We'll talk about it later in the show.

How to get started in a program or yourself and it's very easy.

>> It appears to be but in a lot of people don't think about how to how to go about going to do it.

So the short term and long term benefits of self care these days, can you kind of break that down?

>> What are what's going to be the reward now to start managing our lives for self care?

>> That's a really good question.

Especially short term benefits are easier to go for than long term benefits.

It's difficult to stay with a program when the benefit is a decade off or something but in the short term you're really looking to do things that really help you improve how you feel.

How is your energy level?

Do you get out of bed in the morning ready to actually go into your day or do you drag out of bed feeling like Wow I'd really like to go back to bed now?

You know I'm still exhausted.

>> I don't feel rested.

Do you have the energy to get through your day to accomplish your goals?

>> Do you have time for any fun?

Do you have any fun or are you resting?

Well, So just generally how you feel on a daily basis is one of the main the main goals of taking better care of yourself now.

>> Yeah, for the short term now for longer term I mean we know the lifestyle issues contribute to well over 50 percent of the medical illnesses that we take care of .

>> So high blood pressure, you know, diabetes, heart disease, cancer, stroke risk, you know osteoporosis, all of those are things that you can at least improve your odds of getting, you know?

>> So you know, you may want to live to be one hundred and twenty .

You may want to live to be 80 but nobody wants to get what I call decrepit.

You know, nobody wants to be unable to play with their grandkids or go on a trip or whatever they want to do as they move through their life .

So part of that long term benefit that's kind of nebulous but is important is are you setting yourself up to be able to continue to do the things that you enjoy in life now you mentioned in fact that you are an integrated medicine specialist and before we get more into this conversation I think would also help our audience understand how you get involved in this.

So what in your position do you do?

What is an integrative medicine specialist?

We are looking at the issues that people have when they come into our clinic from a lifestyle perspective from how can we help?

How can we figure out where the problem points are and how can we help you make changes that will help you feel better?

We don't use a lot of medications.

We consider primary care physicians as our partners in people's care.

So if people need medications we tend to have those be managed by their primary care physician.

So we're really trying to help them work on things that a lot of primry care doctors are talking to people about.

But it takes a lot of support to make major nutritional changes or to make these major changes in your life the key word integrative integrate various practices, various people all the above yes.

>> The different therapies we do prescribe some supplements sometimes we prescribe nutritional support.

Sometimes we prescribe therapies that are a little bit different than other like acupuncture or massage therapy counseling.

scope of what can help people achieve their goals as well.

>> OK, we have a call coming in.

It looks like Stan has a question for you.

>> Stan, go ahead.

You're on the air with Dr. Rebecca Mentzer this evening.

Yes, thank you, Dr. Miller.

You mentioned the four pillars with nutrition being one the important ones.

How do you specifically work with your patients when you're educating or counseling them in their nutritional profiles?

You start with a base of tests to kind of establish where they are.

If you could kind of speak to how you work with a patient and in that specific area I would appreciate it.

>> Thank you.

Second question are you still doing acupuncture?

Well, OK, thank you.

I am not doing acupuncture right now.

>> No but thank you for that and the nutrition question of course that is like the most probably complex thing that we deal with is nutrition.

>> There is so much nutritional information out there and there is so much nutritional misinformation out there and so if you you know, go to Google and you try to figure out what you maybe should be eating, it's a minefield.

>> And so one of the things we do do is we have people fill out a week long nutrition diary not from a perspective of change what you're doing like it's like just let's see what your baseline is, you know, and then you know, we have a nutrition team that we have people have a one on one with we also have an a group that we have people go to as well for just baseline nutritional information.

And I think one thing you know, no matter what kind of silo that you see for nutrition, one thing that most people agree on is that a whole Foods is little processed food as possible approach is probably the best.

You know, some of the other stuff you're kind of changing macros, right?

Are you kiddo are you vegan?

Are you this are you that are you what are you leaving out?

>> But if most of the food that you're eating as Whole Foods that means you have to really get the unprepared food and cook something anything pretty much in a box or a package is considered processed.

>> You know if you're eating you know, 80 percent of your diet whole foods and you can get that processed food down to 10 to 20 percent, that's a huge benefit data more and more data is coming out that highly processed and processed foods are really bad for our health .

>> Yes, we hear more so that's kind of where we start.

OK, very good.

And you just break it down and figure out what this person really needs any type of testing maybe blood testing to find out what blood levels are or anything of that nature.

> Is that necessary sometimes yes.

And we often do nutrient baselines at least for some of the bigger nutrients and especially if people have really poor diets and aren't taking any kind of nutritional supplementation to you know, just to kind of get a sense of of really what people's status is and what we may need to supplement while you're working on nutrition now in the green room, that's a fancy name for basically a kitche in the back where we we talk about things before show.

>> But Dr. Mentzer was painting a picture of her typical patient.

Of course you treat men and women but you said it leans a little more on the women's side as far as the population of your patient base in treating now why is that?

I don't really know.

But a lot of women are really focused on and interested in their health and they they tend to come to physicians more than men and men tend to I think power through things a little bit more and so I maybe that's part of it.

>> I don't really know that's certainly not one hundred percent that's a broad generalization.

>> Well, is that the role that many women play or the role that they they have to play at being a mother, a wife taking care of people also many women for the most part I can guarantee you are working maybe at least a part time job if not a full time job, sometimes a couple of part time jobs.

>> So the women do they need a little bit more support because of that because they're pretty much the the main pillar of a household as far as the needs of thir family members?

>> I think that's absolutely true because I am seeing every day I see women in my practice who are really struggling under that burden, which is really why I like self care is important because you know, often people who are caregivers of you know, whether it's men or women or you know, caregivers tend to not have themselves on their list if they're on their list at all, they're on the bottom.

Oh, I'll do whatever when I get done with you know, eighty six things more often than not it's not even a thought.

>> Yeah.

In fact it's family dynamics have changed so much.

I mean if you compare the fifties to what they are now I mean they are just totally blown up.

>> Yes but I can still see that the women being the leader of the household and making sure everybody has what they need because they're nurturers naturally and so that makes sense.

Some of the points that you sent to me via email regarding to show some things you want to talk about you said self care does require some time and attention.

>> We've already looked into that.

You've got to make time for it.

You got you got to make it work and you got to practice the things that you learn you do but you have to I mean there's kind of two points I'd like to make about that.

>> The first is self care is not selfish if you are are just going and going and going and going and nothing is renewing you.

>> There's a limit to that.

You know, like you can't do that forever without significant consequences to your own health and then if you're still needed for these things that you've been doing now you're struggling.

So if you know if your main goal is even to be able to take care of your family or you know, extended family or whatever it is on your care list, you've got to you've got to have some self care in there so that you can continue to do that.

>> I'm glad you brought that up because I think that could be seen differently by various people self care or as you said what would say a selfish selfish people perceive it as selfish and some of that's cultural.

>> Well, yeah, that makes sense.

But as you mentioned, you still have to take care of yourself to give yourself to others.

>> Yes.

You know and back to the issue about I just want to make this point many women are raising their families by themselves these days.

>> So add that to the stack.

Yes.

OK, so another thing said taking care of oneself is as important as caring for those around us who need care which is kind of another offshoot of what we were just talking, huh?

Yeah.

And we're talking about like how do you like kind of how do you implement this?

You know, sometimes I have people who tell me you know I get up at five a.m. and they literally are going until 10 a.m. 10 p.m. when they face plant into bed.

Well, you can't tell them go to the gym and exercise for an hour.

>> No, like that's not realistic, you know, so you really have to find out where people are in their lives and you really you know, if you're just trying to do something for yourself at home, you know, really think about it, push on something that's easy and push on something that it doesn't have to be a massive change.

You know, if you're not getting enough sleep really look at that.

Are you scrolling Facebook for an hour at that is not a good thing to do instead of sleep even if you're like oh this is my downtime, I'm scrolling Facebook.

If you're sleeping four or five hours a night and you're spending an hour on Facebook, that's not adequate like that is not equivalent.

>> You may feel relaxed but that's doing you harm so you can push on little things like that where you just look at your habits and you know, are you you know, could you get to bed a few minutes earlier?

>> You know, are could you you know, let the laundry go and go about a half an hour earlier?

Well, if you're sleeping short amount of time which is less than seven hours for an adult, seven to nine is what adults need.

You're better off to go to bed and pick up the laundry in the morning, throw it in the washer when you are getting your kids out the door for breakfast or something like so just little tweaks like that you don't have to start with massive amounts of time.

You have to kind of look at ways that you can add something.

You can take five minutes and just do a quick prayer, practice a quick meditation practice just sit down and stare at your toes.

>> I mean, you know, whatever just kind of makes you just just sit and do some deep breathing.

>> The mindfulness I think.

Yes.

Yeah, that's a kind of I don't know if it's a catch phrase these days but you hear a lot about mindfulness now in fact where I work full time we even have courses on that from time to time.

>> Mindfulness based stress reduction is really helpful.

It's very impactful.

It does it does help.

Caring for oneself allows us to continue caring for others.

You have to have some gas in your tank.

>> You just touched on that as well.

You got to get your rest.

By the way, are they still saying that you get the best sleep you have to sleep those six to eight hours straight through?

I mean it's not good to take a four hour sleep, a night sleep break and and maybe take a couple hour nap during the day if you have a moment.

>> I know a little bit better than none but does that work?

Sleep stages are relatively complex that first four hours of sleep is when we tend to really do a lot of healing and memory integration is that the mode of sleep know that actually is your later half of sleep so your deeper sleep is is in your first four hours and then your REM sleep tends to come on later on in your sleep and so giving up one or the other that's problematic sleeping in the middle of the day is not you know I don't know what your sleep cycles are like that on the other hand if you you know, getting four hours at night and if you can sleep two hours in the afternoon that's much better than getting four hours at night and that's it.

>> You know, very few people can sleep short like that.

That actually is a genetic trait.

Most adults need seven to nine hours to really fully rested.

>> I'm there and kids need up to ten and we are over scheduling our kids and teenagers are not getting the sleep they need.

Their school schedule starts too early and they're overcommitted, you know, so you this is starting in really young age where we just our culture see sleep as an endless bank of time from which we can withdraw from no consequences and that's not true lack of sleep.

It increases your risk of cognitive decline.

It decreases your attention.

It decreases your memory.

It increases your risk of high blood pressure and weight gain and insulin resistance and sleep is really one of the major keys.

>> It's a big key and it's probably one of the easiest things to push on because a lot of people are kind of wasting time around bedtime for whatever reason that they can grab an extra thirty minutes forty five minutes or whatever.

Yeah, but getting enough rest eating well we've talked about that finding ways decompress getting the stress off your shoulders.

>> What's a good way to decompress.

Well you can do something as simple as just some deep breathing and that's abdominal breathing or belly breathing where you're you're not you know all breathing up here.

>> You're just you're letting your abdomen relax and your you know, your belly is kind of pushing out and you're just deeply filling your lungs by stopping and taking deep breaths.

>> Yeah, that's something that can be done while you're sitting at a desk absolutely watching TV.

>> Yes.

Yeah.

I'm squeezing these little things and I get your point.

I mean if you don't have time to do these things you've got to find time but it's not going to take a major requirement.

>> Right.

You don't have to like rearrange your life where you need to find three hours a day .

>> It's not realistic for ninety nine point nine percent of the population.

Well, and we have a list here is well going down also speaking of work, changing a difficult work situation because I know a lot of people take their work angst home with them.

>> Yes.

Which of course gets integrated in the family life .

>> I'm sure the up and work stress is huge and you know the last one years now we have you know, we have devices you know, I've talked to people whose bosses are texting them at one o'clock in the morning.

Oh.

You know, and people take their laptops and they're like oh, I'm just I'm just checking my work email for a half an hour a day but I'm on the beach.

>> It's all good.

>> No, they're not on vacation.

They're still at work.

Their brain is still engaged so they don't come back rested and the data is really clear if you disengage completely you come back your mental health is better.

You're less anxious and depressed, you're more rejuvenated and you're in a better employee and you're more productive.

>> Yes.

So you do better to disengage and 40 percent of Americans leave you on the table every year.

>> Yeah, and that's they don't take they need to take it and it's there you're getting paid for it.

I'm an advocate of that.

>> That's what it's there for .

There's always work when you get back to it.

Yes.

it's to be and probably everybody knows what it's like to come back and you're like oh maybe I shouldn't have gone.

>> Well but you're better able to to plow through the pile when you get back if you're rested and you've had a good time and gotten your way and if you have some good coworkers who are on the same page with you hey, we have another call coming.

>> In fact it's from Leslie and let's go ahead and ask your question for Dr. Mintzer.

>> Oh, OK. Leslie wanted us to go ahead and just read the question.

>> That's perfectly fine Kam eating bananas improve a person's mood.

>> Well I know chocolate does that for me.

I really don't know about that.

I have to be honest bananas are a good source of potassium.

>> Yeah um and I just want to make them last longer.

Yeah I'm always throwing one or two I'm sorry Leslie that one I'm not sure OK but that thank you for your question.

>> You know we talked about and we've only got a few minutes left but I want to address this before the show ends because it's so important but taking care of oneself is as important as caring for those around us who need care.

And I have something from the AARP that I just came I just found today as a matter of fact it was a twenty twenty three report found that 40 percent of all caregivers cite the emotional stress of juggling caregiving and working as their biggest challenge.

So that's what they have to balance the working and the caregiving.

More than half of caregivers find that caregiving makes it hard to take care of their own mental health .

>> Yes, yes.

And I've seen that within my own family.

>> How is that something?

How could you address that issue?

What do you need to do that is a that is a very challenging problem and you know, so many people and more people every year are caregivers because just because of the way our society is structured and we tend to be many people that I talked to our caregiving for people who are not in their home.

>> So they're actually they've got travel time as well and so that adds another layer in it.

>> The care ease needs tend to really supplant the carers needs and so as people get deeper and deeper into that they have a harder and harder time doing anything really for themselves except surviving.

>> Yeah, and that boy some of that some of that depends on other resources.

Some of it depends on a willingness sometimes there are resources available and people are unwilling to get them partly sometimes because the person being cared for is like I don't I don't want someone I don't know in my home.

>> I don't want this.

I don't want that.

But those times when another person is caring for their loved one gives them an opportunity to do something for themselves whether that's just relax and have a you know, go to church or or relax or read a book for ten minutes or actually go to the grocery store caregivers needs needs some respite and so that's a conversation people who are caregiving have to have with the person they're caring for is sometimes those other resources do exist and they're not being utilized and but that's a complicated conversation and it's sometimes often one or two people in a family are doing all the caregivng and there are others in the family that are nearby.

>> Right.

You know and you know, we have situations in fact Indiana has a program now it goes through Medicaid that you can actually basically hire a family member or a friend to live with you and give you care.

>> But my gosh, I mean I'm sure it doesn't pay all that much to be rewarding I'm sure especially toward the end and so forth but and helping that person live a better quality life .

But if you were living with that individual taking constant care, you have to come up with a plan that you have respite, that you have a chance to break away and get away because people can be, you know, 24 hour care and there are people pwho are really honestly twenty four hour care living at home with one person.

>> Yeah.

And and you want to avoid and prevent caretaker burnout.

>> Yes.

And that's a huge problem.

Yeah.

Then we need to talk about that some other time when we have that would be that could be its own.

>> Yeah let's do that's a very a complex topic.

We'll all set that up and we'll definitely get into that one of these days very soon.

Well that's rap as they're telling me it was quick I told you I was going to fly but I didn't fly and you are an excellent guest.

Thank you very much for being here, Dr. Mansour.

Thank you very much for having me.

Very important topic.

Absolutely.

Thank you for watching.

Thank you for your phone calls.

See you next Tuesday.

Until then, good night.

Good