I was honored to be featured on The Madeline and Becca Podcast where I discuss my career path and how I opened BreatheMD. If opening a medical practice, doesn’t interest you, then go to their podcast to hear other women give advice on professional self-confidence and career success.
The Madeline and Becca Podcast: Opening a Medical Practice with Dr. Mary Talley Bowden
Since early March, my team at BreatheMD and I have tested almost 4000 Houstonians for COVID-19. As an outpatient facility, we are fortunately seeing younger patients with mild or no symptoms test positive, despite the recent surge in cases.
With less severe symptoms, people often wonder if they need treatment. Early-on, hydroxychloroquine and azithromycin were widely prescribed for outpatients with COVID-19, but since data on the effectiveness of these drugs has not been convincing, most physicians no longer routinely prescribe them. Recently, steroids have shown promise in hospitalized patients with COVID-19 but due to the side effects, are not recommended for everyone.
At BreatheMD, we advise patients with COVID-19 and mild respiratory symptoms to use a heating pad on the chest, take high-dose Vitamin C, and hydrate as much as possible. If these measures are not enough, we provide breathing treatments (hypertonic saline and albuterol) to patients while they stay in their cars and can give IV fluids should patients show signs of dehydration. Tylenol is advised for fever and body aches.
Many patients wonder how long to quarantine and if/when they should retest. Unfortunately, the CDC’s guidelines are not applicable to every situation and leave some room for interpretation. I advise my patients to wait at least a week after symptoms have completely resolved to retest, and since I often see patients test positive two to three weeks after their first test, waiting longer is better if possible. I believe most people should retest with a negative result before leaving quarantine, but it’s not absolutely necessary if the patient is not required to interact with large numbers of people. Without a doubt, however, the longer people quarantine and wear masks out in public, the sooner we put this pandemic behind us.
For family and friends who have come in contact with patients with COVID-19, the best time to test is at least five days after exposure to avoid a false-negative result. Not all people with significant exposure to COVID-19 get infected, as I’ve seen many families where only one or two people contract the disease.
For patients who have recovered from COVID-19, we recommend reaching out to Methodist Hospital to see if they can help others by donating their plasma (www.houstonmethodist.org/blood-plasma-donation).
For more information on COVID-19, please see our website, www.breathemd.org/faqs-covid.
Our answers to the most common questions regarding COVID19 testing.
Read moreIn the last five days, we have tested 65 patients. We are still waiting on results for the majority of these people, but so far all tests have been negative.
Our clinic is an outlier in that we are testing anyone who wants to be tested. LabCorp has been running the test since March 5th, but this was not publicized to the medical community. We only found out by doing our own research and started testing patients on March 13th.
One of the reasons we are not limiting testing is that we anticipate that early, aggressive respiratory intervention will prevent hospitalization in our patients who becoming ill. We do not agree with the hands-off approach most physicians are taking with their patients. We have seen many people who are in need of outpatient respiratory support in the form of inhalers, nebulizer treatments and/or antibiotics. We are taking extreme caution in our clinic, using the highest levels of sanitation we can, while also taking care of people who need to be cared for.
For evidence-based information on management of this virus, we highly recommend following the Center for Evidence-Based Medicine.
So that we can focus all our efforts on patient care, we are no longer scheduling patients over the phone; please use the appointments page on our website to make an appointment. We require everyone who enters our clinic to wear a mask. If you do not have one, we have non-disposable surgical masks available for $10.
COVID-19 is a very aggressive virus and much more contagious than any other diseases we’ve seen in our lifetime. For perspective, check out this graph comparing the spread of SARS in 2002-2003 to COVID -19:
To date, there are over 162,000 cases of COVID-19 whereas the number of SARS cases was just over 8000.
People who are infected may be asymptomatic for up to about a week before developing symptoms. The most common symptoms are fever, cough and shortness of breath, but some people also have nasal congestion and loss of smell and taste. Once infected, the virus has been shown to replicate and shed for a median time of 20 days, with the longest documented period being 37 days.
Social distancing has proven to slow down the spread of infectious diseases, not only in past epidemics but also in the current COVID-19 pandemic. It is imperative that we eliminate all non-essential social interaction to contain this virus. This means that until transmission starts to recede, we should refrain from dinner parties, play dates, birthday parties, restaurants, movies, beauty appointments, gym classes, air travel and other forms of mass transportation when possible. Spending time outdoors has been shown to boost the immune system. Take-out and delivery is preferable to eating in restaurants and should be safe as long as restaurants continue to follow normal sanitary guidelines. DoorDash just sent out an announcement that allows people to request a no-contact delivery.
Although certain segments of the population are at higher risk from experiencing complications from COVID-19, we are all at risk for becoming infected and spreading the virus. Please don’t assume that you aren’t at risk because you’re young and healthy. The majority of victims during Spanish flu of 1918-1919 were healthy adults between the ages of 20-40.
Should you suspect that you have the infection, we are able to test you at BreatheMD. Our typical protocol is to first test for strept and flu in the office; if both are negative, then we test for Covid-19. Currently results are taking 3-5 days. We may also order blood tests and/or a CT scan of the chest to help with the diagnosis. We advise anyone who suspects they have the virus to wear a mask in public. An N-95 mask is not necessary, and we have cloth masks with filters that protect against viruses available for sale at our office.
For up-to-date information on Covid-19, please refer to the World Health Organization website and the Harris County Health Department website.
Doctors now believe sugar is just as addicting and harmful as tobacco. Here’s why.
While the recommended allowance is no more than 30g of added sugar a day, Americans consume on average 20 tsp or 80g per day. Did you know that one 20 ounce orange Gatorade contains 36g of sugar?
Consequences of too much sugar: Metabolic Syndrome and NAFLD
Metabolic Syndrome: 25% of the US population shows traits
Cluster of diseases that significantly increase risk of cardiovascular disease - hypergylcemia, hypertension, dyslipidemia, insulin resistance, central adiposity
Waist circumference >35in, Triglycerides >150mg/dL or on drug treatment for elevated TG, HDL-C <40mg/dL, type-2 DM, BP 130/90mm Hg or on anti-hypertensive therapy
Non-alcoholic Fatty Liver Disease (NAFLD): 20-30% adults
Excess fat accumulation in the liver - major cause of chronic liver disease in Western societies. Estimated to affect 7% of nonobese youth and up to 70% of obese youth. Typically asymptomatic and discovered incidentally.
All sugars are NOT created equal: Fructose vs Glucose
Ingested glucose bypasses the liver and goes straight to the brain and muscles to be used as energy. Excess glucose is stored as glycogen primarily and secondarily as fat.
Fructose, on the other hand, is first metabolized in the liver, does not trigger insulin or leptin release, and is more readily converted to fat than glucose. Excess fructose consumption is linked to increased risk of fatty liver disease, weight gain, and diabetes.
HFCS contains chemical toxins like chloralkali which has mercury in it. Red flag for very poor quality food.
Agave nectar contains 70-90% fructose and is 4 times sweeter than sugar.
The healthiest options for adding sugar to your diet are raw, local honey and Grade A/B maple syrup. Both contain minerals, antioxidants, and amino acids, have a low glycemic index and relatively low fructose content.
Most common sources of fructose:
Table sugar
Agave (4x sweeter than sugar)
Fruit juices
High Fructose Corn Syrup (HFCS) - prevalent in processed foods
Artificial Sweeteners:
San Antonio Heart Study, 5000+ people over 10 years
· More than 21 artificially sweetened beverages/week associated with double the risk of obesity
Artificial sweeteners are far more potent than table sugar and HFCS - over-stimulation of sugar receptors from frequent use may cause less intensely sweet foods, such as fruit, to be less appealing and unsweet foods, such as vegetables, to be downright unpalatable
Signs and Symptoms of Sugar Imbalance/Prediabetes:
Fatigue, irritability
Excess thirst, excess hunger, excess urination
Blurry vision
Slow healing cuts
Tingling in hands and feet
Causes of Sugar Cravings:
Stress - leads to increased cortisol levels
Cortisol is your body’s ‘fight or flight’ hormone - mobilizes sugars to provide energy to muscles
Your body thinks it needs sugar to overcome an obstacle, leading to ‘stress eat’ sugar foods
Not enough protein and fat in the diet
Gut dysbiosis - yeast overgrowth (yeast loves sugar)
Tips to Curb Sugar Cravings and Balance Blood Sugar
Learn how to manage chronic stress
Eliminate “naked” carbs - pair carbs with fat, protein, and fiber
Be prepared - don’t leave home hungry or without snacks
Glycemic Index, Glycemic Load and Satiety Index
The Glycemic Index (GI) indicates how high and how fast a food is likely to raise your blood sugar. Our body performs best when our blood sugar level is kept relatively constant. If blood sugar drops too low, we become lethargic and/or experience increased hunger. If blood sugar goes too high, insulin is released, which causes excess sugar to be converted to fat. After exercise, foods with a high GI may be helpful in speeding recovery, but otherwise we are better off avoiding high GI foods. The GI can vary based on individual differences and the way food is prepared.
The Glycemic Load (GL) takes into consideration the amount of food ingested and is a more accurate way to predict your body’s glycemic response. When looking at GL, it is important to pay attention to the calorie content. Peanuts have a very low GL but are also packed with calories - low GL foods are not all good if it takes a large amount to satisfy your hunger.
The Satiety Index ranks different foods on their ability to satisfy hunger. The median score is 100 and is based on white bread. Anything above 100 is more filling and below 100 is less filling than white bread.
Carbohydrates with lowest GL that are highest on the Satiety Index:
Snacks - Popcorn (SI 154, GL 6)
Vegetables - Boiled potatoes (SI -323, GL - 21)
Fruits -
Oranges (SI - 202, GL 6)
Apples (SI - 197, GL 6)
Grapes (SI 162, GL 11)
Brown pasta (SI 188, GL 17)
Oatmeal (not instant) (SI - 209, GL - 12)
Whole grain bread (SI 154, GL - 7)
You can lower the GI of snacks by pairing your carbs with fat/protein/fiber.
Avocado toast + egg
Apple + peanut butter
Tortilla chips + queso and guacamole
Pasta + meat sauce
Pasta + nuts + EVOO
Cooking, grinding, pulverizing food increases its GI. Boil pasta for a shorter period of time to lower its GI. Adding cinnamon to your diet has been shown to lower fasting blood glucose and glycemic response.
All doctors have been prodded by their patients to prescribe a Z-pak, and most, if not all, have begrudgingly succumbed to that request at some point. The reluctance is universal and has less to do with the patient crossing an unspoken boundary and more to do with the physician not wanting to add to the huge problem of antibiotic-resistance.
Some important facts:
Between 90 - 98% of acute sinusitis are viral and won’t respond to antibiotics.
There are over 200 viruses that cause the common cold.
Only 5 - 10% of sore throats are caused by strept throat.
The average duration of an upper respiratory tract infection is 7 - 21 days.
The average duration of a cough is 18 days.
The most common cause of ER visits in children is from adverse side effects from antibiotics.
Z - pak’s increase the risk of fatal heart events.
The incidence of antibiotic-resistant infections in the US is currently over 2 million per year and climbing.
At BreatheMD, we use next-generation DNA sequencing to identify what is living in the sinuses of patients with chronic sinus problems, whether it’s bacteria, viruses or fungi. The test identifies 100% of microbes within a sample with 99.9% accuracy, provides information about antibiotic resistance, and gives an appropriate antibiotic recommendation if necessary. For more acute infections, we are able to test for strept throat and influenza virus on-site.
The common cold cannot be cured with a pill, but here are some things to do to shorten its duration:
Do everything you can to thin the mucous.
Hydration
Saline irrigations at home, adding a drop of baby shampoo and betadine to each batch
Mucinex, an over-the-counter medication that thins the mucous (but make sure to take with a full glass of water)
Stop taking (or lower the dose) allergy pills that thicken mucous (unless your allergies are severe)
Plenty of hot tea and chicken noodle soup
Slow down your caffeine intake
Hot showers/steam room
Rest. Listen to your body.
Sinus Therapy at our clinic to drain the mucous
Echinacea, turmeric, elderberry, ginger, and vitamin C
Infrared Sauna to decrease inflammation and increase circulation
For night-time cough, warm up a dollop of raw honey and swallow (don’t give to infants under 1).
Cold air through the mouth can trigger cough so focus on nasal breathing if possible. At night, keep the room warmer than usual if mouth breathing is an issue.
Please feel free to add any tricks you’ve found helpful to kick your colds in the comments section.
Chronic inflammation plays a central role in a host of diseases, including cancer, heart disease, diabetes, asthma and chronic sinusitis, and even Alzheimer’s disease. Inflammation is essentially your body’s immune response - helpful in acute situations, but harmful when the underlying cause persists and the response lasts for months or years.
Causes: Imbalanced gut bacteria, harmful bacteria/parasites, chronic stress, some medications, excess weight (extra fatty tissue produces inflammatory cytokines in the body)
Symptoms: decreased energy and fatigue, sleep disturbances, brain fog, skin problems, abdominal pain/bloating/gas, joint pain, headaches, irritability/mood swings/anxiety/depression
Dietary contributions:
Processed vegetable oils: Omega 6 oils trigger the body to produce pro-inflammatory mediators in our body. The ideal ratio of Omega 6 to Omega 3 oils is 1:1, but the typical Western diet contains a ratio of 20:1. Examples of Omega 6 oils to avoid are vegetable, canola, corn, soybean, peanut, safflower, cottonseed, grapeseed, and sunflower oil. Use avocado, olive, coconut, flax, walnut oil and ghee instead.
Refined flour: A whole grain of wheat has 3 layers - the bran, the germ, and the endosperm. Refined flour strips the grain down to the endosperm. It’s then bleached and oxidized to give it the pure white color. The majority of nutrients are destroyed in the this process, including fiber. Look at food labels and try to avoid items containing “enriched flour.”
Gluten: A primary constituent of gluten called gliadin has been shown to cause intestinal stress through activation of zonulin, a hormone that signals the tight junctions of your intestinal wall to open… leaky gut. Once triggered, zonulin stays active for 90 days. Gluten is not only found in bread and pasta but because of its binding properties, is often added to random items such as medications, lunch meat, shampoo.
Sugar: Excess fructose consumption stimulates the body to deposit extra fat in the liver, contributing to fatty liver disease. Fructose does not trigger insulin release or leptin like glucose does. Stick to honey and maple syrup as sweeteners and limit added sugar intake to 6 tsp/25g or less (women), 8 tsp/35g of less (men).
Artificial Sweeteners: These overstimulate sugar receptors, leading to sugar addiction and making less sweet foods much less appealing.
Expired Items in Pantry/Freezer: Your body has a harder time breaking down expired food. Throw away spices older than 2 years, anything in the freezer that has frostbite, expired condiments.
Other dietary sources of inflammation:
Foods containing non-organic corn and soy as 94% of these are genetically-modified
Dairy from cows fed hormones and antibiotics - look for “grass-fed, pasture-raised, rBGH-free, rBST-free”
Food colorings
If you are wondering what's left to eat, I will cover anti-inflammatory foods in my next post. For now, start reading food labels, become aware of what you’re consuming. Aim for a B - 80% compliance is good enough and much better than what you may be doing now.
Stay healthy this holiday season — great tips for kids and adults
Decking the halls. Wrapping gifts. Caroling parties — all are great holiday traditions. But catching a cold or dealing with seasonal allergies can turn anyone into a grinch. This year, take advantage of these health tips and start a new routine — one where you and your family find your relief and are healthy and happy all season long.
1. ‘Tis the Season for Sinus Therapy. From boosting your immune system to making time to keep up with your exercise regiment, looking after your body this holiday season can keep you in a joyful mood. Drink plenty of water, take your regular vitamins and schedule your routine sinus therapy to ward off sickness. BreatheMD offers three levels of sinus treatment depending on your needs.
- Sinus Rinse: Quick 15-minute appointment to flush your sinuses free of toxins and microbes.
- Sinus Cleanse: In just 30 minutes you’ll experience the Sinus Rinse coupled with a full head, neck, shoulder, face and scalp massage.
- Total Sinus Treatment: Both the Sinus Rinse and Sinus Cleanse, coupled with a topical anti-inflammatory CBD salve and herbal compress.
2. Have Yourself a Stress-Free Holiday? Everyone knows the holidays can be overwhelming. There’s the shopping, decorating, cooking and entertaining that comes with the holidays, plus your everyday to-dos. Maybe you or your significant other is finishing a big project at work or your kids are prepping for final exams. To help combat stress and lower blood pressure, consider infrared sauna therapy. Inducing a deep sweat, infrared saunas make the heart pump faster, which increase blood flow and circulation while lowering blood pressure.
3. Give Yourself a Gift. Feel and look your best this holiday season by starting Thermage®. Requiring no anesthesia or downtime, radiofrequency skin tightening regenerates and grows collagen down to the dermis. Results improve over time, so book your appointment soon!
4. Enjoy the Winter Wonderland. No, you’re not allergic to the holidays. But you can be sensitive to food and environmental substances, like pet dander, pollen and nuts. Stop suffering with a pain-free, 30-minute skin prick test or blood test. Once we know what affects you, targeted immunotherapy can help you feel better.
5. Have a Silent Night. Is your snoring (or your partner’s) keeping the house up at night? If so, it may be time to schedule an appointment with Dr. Bowden to put a treatment plan in place.
Book an appointment for one of our services today to be healthy and happy this holiday season!
Chicken soup has long been regarded as a remedy for the common cold, and scientists have data to prove it.
My mother gave me this recipe, a variation on chicken noodle soup. It has a bit of a kick to it that will really drain your sinuses.
Ingredients:
1 head of green cabbage
1/2 red or Vidalia onion
Avocado oil or peanut oil
Chicken broth or bone broth
Angel hair pasta or vermicilli, 1 package
1 pint of pico de gallo
Directions:
Chop cabbage and onion into thin slices and place together in a medium or large bowl.
Heat oil in large, deep frying pan.
Break noodles in half and add to pan. Stir frequently until noodles are brown (careful not to burn the noodles.)
Add broth until noodles are covered and cook until noodles are soft.
Add pico de gallo to noodles and broth and stir. Typically you will need to keep adding broth to maintain the consistency of soup.
Add cabbage/onion mix to the bottom of a soup bowl and pour noodles and broth over it.
Pico de gallo added to noodles and broth.
Most of us are familiar with the basic tenets of sleep hygiene…. keep a regular bed time and wake time, no caffeine after lunch, don’t exercise or use electronics close to bedtime, don’t nap, don’t do anything in your bed besides sleep (and….) These standards have been around for the last few decades but recent advances in sleep medicine have led to better advice and better treatments. I’ve created an updated list of tips to help you fall asleep more easily - without a prescription.
Use a weighted blanket. Target sells one for about $40. For a more stylish option, check out Bearaby’s blankets. We use the “Tree Napper” in our clinic.
Use a weighted eye pillow. Both the weighted blanket and the weighted eye pillow stimulate the parasympathetic nervous system, and covering your eyes releases melatonin.
Eat a small snack (I like Zone Perfect bars) and a glass of milk before bed. This diverts blood flow to the stomach and helps quiet the mind.
Learn Transcendental Meditation (TM.) . TM has been in existence for over 5000 years, and the benefits are scientifically-proven to help a variety of medical conditions. TM is easy to learn, easy to maintain, and the most well-studied of all the meditation methods. The Beatles were big believers and today, Jerry Seinfeld, Paul McCartney, Dr Oz and Tom Brady are among the many advocates. A 20 minutes session of TM reduces the body’s oxygen consumption by 16% (compared to 10% during sleep) and dips your brain into alpha 1 activity, lowering cortisol levels and releasing stress from all over your body. To learn how to do TM, find a local TM center near you, or try it at home using this self-help guide.
Get an air filter for your bedroom - cleans the air and provides white noise.
OTC Medications:
Tylenol PM is just Tylenol + Benadryl. Benadryl is safe and non-habit-forming. I tell my patients to take 2 Benadryl and a melatonin if their insomnia is a moderate to severe problem. When choosing a dose of melatonin, lower is better.. higher doses create an imbalance in the brain’s sleep-wake system.
Magnesium can also be very helpful to take before bed, especially if you’re pregnant. It’s a natural muscle relaxer and what is used to treat pre-term labor. I took it nightly with all my pregnancies - stopped my leg cramps, helped me sleep and kept me regular.
CBD helps with anxiety, is non-habit-forming and has been shown to promote sleep. When buying CBD, look for “THC-free”… the THC is what gives people the high.. and the positive drug test!
Prescription Medications:
Avoid benzodiazepines at all cost as they are strongly habit-forming.
If you are struggling with insomnia, in addition to the above measures, exercise more, eat better, get a massage, treat yourself. Only when all else fails, should you think about taking a prescription drug.
There are a slew of prescription sleep medications out there. The newest one, Belsomra, has a unique method of action that sets it apart from the others by targeting orexin receptors in the brain. Orexin is a neuropeptide that increases wakefulness; it was first discovered in narcolepsy patients who have insufficient amounts of it. Belsomra is safe, effective and unlike most other medications for sleep, has no hangover effect. Insurance companies, of course, usually won’t pay for it ($$$$) unless other, less expensive, medications have been tried first.
If you wake up and can’t go back to sleep….. the best trick I know, because it happens to me frequently, is to have a small snack and a glass of milk. Blood is immediately diverted to your stomach, the parasympathetic nervous system is stimulated by digestion, and your mind will quiet down.
What have you found helpful for insomnia? Please leave your comments below!
3600 Kirby Dr. Suite F Houston, TX 77098
713-492-2340
frontdesk@breathemd.org
Monday - Friday 8:15 a.m. - 5:00 p.m.