What does appetite mean exactly? We like to think of it in terms of a desire for food. But it is actually more properly termed as the power that tends us toward some object that we see as good which acts through the body. Even if the object is bad for us, we can still seek it under the notion of the apparent good (this is where we have mistakenly assessed it as good). For instance, we all know appetite in relation to food but this word can apply to many things, like a tendency toward hard work or pleasure of some kind. Thankfully, we are focusing on food and drink so we don’t have to worry about those other things.
There are two types to go over – the concupiscible and the irascible. The concupiscible appetite is a tendency toward a good or away from an evil in a simple sense whereas the irascible appetite comes when one has to overcome some obstacle to satisfy the concupiscible appetite. We have inclinations that impel us toward things that are hard or difficult to attain (arduous) like completing your degree or building something. These appetites are moved by our senses, imagination, association power and intellect. To illustrate these points, let me give an example using myself. I have an appetite (concupiscible) for chips and salsa. If I see chips and salsa, my appetite is moved (I tend towards eating them because they taste good!). Here my senses moved the appetite (I saw and smelled them while tasting them will further move it). If I think about them without them present (with my imagination, memory, intellect, association power), then I will move my appetite still. My body chemistry actually changes in response to this movement. The irascible appetite is aroused if I have to drive a long distance to get them (an obstacle I have to overcome). I might exhibit an annoyance that I have to drive to get this but this emotion drives me to overcome that long drive. Both appetites will have their respective emotions or passions which is what we will move to next. The six passions of the concupiscible appetite include: love, hate, desire, flight, delight and sorrow. Love drives all of the others. The five passions of irascible appetite include: hope, despair, audacity, fear, and anger. What I will attempt to do is to try to relate these passions or emotions to what we eat and drink. Love, as part of the concupiscible appetite, is a movement toward a good or pleasant object. For example, the chips and salsa. If the chips and salsa are here and attainable, then the love for it generates an actual desire. Once I obtain the chips and salsa, the desire comes to fruition in joy and delight. But if some other thing impedes that attainment, then the irascible passion of anger (irritation, annoyance, etc) will be stirred up against this impediment and urge us to overcome it. Once it is out of the way, joy or delight returns. The same can be said to avoid evil things (which is moved by a love for the good and in this instance, avoiding evil is good). For example, let’s say I gain more knowledge that eating too many chips and salsa is bad for my health and so now my object of love is my body’s well-being. However, I find eating broccoli and other healthy foods difficult to eat. Love for my health moves me to desire to eat better though. However, the impediment to this is my attachment to chips and salsa. In other words, my love for the pleasure that chips and salsa brings me when I eat it. Hence, because this is arduous, an irascible passion will now arise. Which comes depends on the person and where they are at with dealing with this arduous task. One person may have hope where he hopes in his or another’s capacity to get him to come to the good (eating healthier and ridding himself of his attachment to chips and salsa). Another person may despair where he thinks there is no way he will ever get over this addiction as he does not see it as possible to obtain. This happens because he sees the object of being healthier exceeding his capacity to obtain it. If and when the person does overcome this arduous task, he returns to delight as he has obtained masterful control of his attachment. Of course, true mastery is difficult to get so he can fall back into eating chips and salsa without moderation which then elicits anger as the evil of his addiction has returned and is present. This anger, though, helps one move back towards overcoming this attachment. If is overcome again, one goes back to delight and if not, one can move towards sorrow or depression (because the present evil of this attachment to chips and salsa is still here). Of course, with aid, one can be moved back to hope and eventually joy/delight. You can see the complexity that the human mind and brain contains. Multiple emotions can come from each emotion in this process – I only illustrated a few. These emotions move through us so quickly that we never think about it. But to gain mastery over yourself in this way, you should try to understand these kinds of emotions better! If you know how you respond well to such impediments, then we can begin to draw out the reasons why you may think you cannot overcome the arduous task of overcoming a certain attachment to a certain bad food. If you know that you despair when thinking about losing weight to achieve a healthier state, why is that? Why do you despair? What makes you think that you cannot overcome the hard task of avoiding bad foods and eating good foods? By asking yourself these questions, you are exercising your capabilities of reasoning out what the problem is and finding a solution to overcome that problem and give yourself hope again. By giving yourself hope again, you will then begin to be moved to overcome this hard task. The point I want to make is that we need to rightly order our passions of both appetites so that we can make good choices. Remember that there are instances where it is reasonable to feel fear or despair because when one reasons out that one truly cannot overcome something, then it is reasonable to feel this way. Like desiring to see a parent who recently died but knowing that this is impossible (in this life) since that person is dead so one appropriately can move the passions of sorrow, despair and anger. The key question is: are you truly despairing in a reasonable way with trying to eat healthier? Is it really un-attainable? Or is it that you are letting your appetite for pleasure override what is reasonable? It is reasonable to maintain a healthy balanced diet because that is a true good for your body. Eating outside these boundaries occurs because of a disordered appetite. We must orient ourselves back to controlling our appetites. This will be the subject of a future blog but as a preview, the answer to getting control again is to perform acts that are truly good for you. With regards to your diet, keeping a food journal is a good first step. It keeps you informed of your bad eating habits so that your intellect and will can make more reasonable choices moving forward. By strengthening them through journaling and practice of eating healthier, you begin to take control over your disordered appetites and thus gain more hope that you can indeed overcome this difficult task.
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Strep throat!!! We all know its symptoms pretty well. These can include headache, stomachache, sore throat, and swollen lymph nodes (to name a few.) Over the past few months, it has been noted that cases of "Invasive Strep" are increasing at a rapid rate in Europe and the US. The strains of strep infection that cause scarlet fever are becoming increasingly prevalent.
The age group that this is most dangerous in babies under age 1, as the infection can spread to the bloodstream and cause a lot of damage. Children under ten are the other age group that is most affected. What is Scarlet Fever? Scarlet fever is a term for the rash that develops in patients with strep throat. This rash is caused by a toxin produce by the strep bacteria. The rash can look different in different kids, so it is very important to have "odd" rashes looked at by your medical provider. The strain of strep that causes Scarlet Fever has also been correlated with PANS/PANDAS. What can we do? The most important thing is to get your child in to be seen if they are showing symptoms of strep throat. We will do a rapid strep test in the office, and many times will send the throat swab off for a culture to make sure that our rapid results are accurate. If your child is put on antibiotics for strep infection, PLEASE make sure that they take their medication as prescribed, and that they finish the entire course of medication. With these "invasive" strains of strep, sometimes the child will need a penicillin injection in addition to oral antibiotics. If left untreated, strep bacteria can invade the bloodstream and cause toxic shock syndrome, meningitis or brain abscess, joint infections. Local complications include tonsil abscess, ear infections, sinus infections, and skin infections. If you think your child (or yourself) needs to be seen, please give our nurse line a call! We have same-day appointments available so you can avoid going to urgent care. If the symptoms pop up over the weekend, I don't recommend waiting until Monday to be seen-go to Urgent Care over the weekend. All of this may sound pretty scary, but with antibiotic treatment, the infection will completely resolve without complications Stay well Sarah Lee, ARNP Doing anything outside of your child’s regular routine can be a bit overwhelming and stressful for both parent and child. There are ways to help prepare your child so the experience is more positive and successful. These techniques can be used to help prepare your child for anything new that they may be experiencing such as their first day of school, potty training, a procedure at a hospital or out-patient surgery center, dental visit, and more. These are 3 ways to help prep your child for a successful visit to IFM.
Each day leading up to the appointment, repeat a similar conversation. On the way to the appointment, give one more reminder of what they can expect when they arrive at IFM. The more you talk and prepare them, the better they will feel going in. They may still be nervous, or even cry, and that is ok. Remind them that you are with them, they are safe, they are allowed to feel that way, and soon it will be over.
Parent: “Oh, I understand that you don’t like the way this medicine tastes. It is important to take your medicine because it will help your body feel better. How about I give you your cup of water so you can take a big drink after you take your medicine?” Dolly: “well, okay” Parent: “Here you go,” (hands water cup to Dolly and then gives her the medicine. Dolly then takes a big drink of water) Dolly: “That wasn’t so bad.” Parent: “Great job! I knew you could do it!” Sometimes a little encouragement goes a long way.
Utilizing these 3 techniques together, can really make a big impact on how your child’s visit to IFM will go. We hope this will help you and your child enjoy your experience here at Integrative Family Medicine, we look forward to your visit!
As we usher in the New Year, it's important to remember that every day is an opportunity to improve yourself. So many of us make resolutions at this time of year—and while they're great and all, they can be hard to keep up with. Instead of just resolving to get more exercise or work on your finances, why not resolve to improve your mental health?
Here are some tips for starting off your year right:
You can book an appointment with our Psychiatric Nurse Practitioners today. Let us help you be at your best in 2023 Dr. Justin Janss https://www.integrativemediowa.com/justin.html Dr. Danielle Fitch https://www.integrativemediowa.com/danielle.html When it comes to those three little words with a great big meaning, how comfortable are you verbalizing them to a friend, a spouse, or even your own child? Many of us struggle to say the words even if we are feeling them. I am here to tell you that the importance of actually verbally saying to your child, “I love you,” is great. In this blog we will look at the why and the how of saying I Love You. Research shows that children who feel a strong sense of acceptance and love at home, are more likely to develop a positive self-esteem. Having a positive self-esteem has many benefits such as: positive body image, healthy relationship with food, better social relationships, more success at school and work, and improved mental and physical health. Forming a positive self-esteem as a child will lead into adulthood, and ensure an overall happier more successful life for your child. So that’s the why, but what about the how? How do we incorporate saying and showing love to our child when that is not the norm for us? If you are like me (and many of us out there) I did not grow up in a particularly affectionate family. I knew I was loved but the words were not often spoken. I have found ways to incorporate the words into my child's everyday routine. For example, when my daughter wakes up I take two minutes to snuggle with her and tell her I love her. I tell her how she makes me feel so happy, and the best part of my day is spending time with her. This two minute interaction starts both of our days off with love. It fills our cups, and we are ready to start our day and tackle whatever comes our way. So I encourage you to bring the “I Love You” into your everyday conversations with your children. Show them love by giving them quality time, listening to them, and being silly. Give them examples of healthy loving relationships, with friends, family, and your partner. All of this will build trust between you both, promote a positive self-esteem, and even release some good serotonin. Here at Integrative Family Medicine, we love that you have become a part of our family. This practice was created to spread love and healing, and provide the care you deserve! Thank you for being a part of our story! Stephanie WelchPediatric Sensory Specialist T’was the week before Christmas and all through the house
Every creature was stirring since the early AM, (probably) even a mouse On Sunday, I made gingerbread houses with my two toddlers. Yes, I made them because what 3 year old and 18 month old have the fine motor skills to hot glue some graham crackers together? More from our founder and CEO, Kara, on staying present in this season. What is the Fourth Trimester? We all talk about the different stages of pregnancy in “trimester” terms. Generally the first 12 weeks after your baby is born is referred to as the Fourth Trimester. There is no real timeline in this time period. No “your baby is the size of a fruit” to look forward to. Everything is focused on your new baby and their development, smiles, coos, crawling—-but what about mom? Many times we get a little lost in the shuffle. This season of life is so busy, we lose sight of our own health and wellness. Between lack of sleep, returning to work, finding daycare, traveling to see family, feeding, snuggling, and changing diapers, there are not enough hours in the day! Generally when you deliver the baby, you see your OBGYN/Midwife at the 6 week postpartum appointment, then possibly no further visits for a very long time. There are many studies that have been done regarding careful follow up for moms that are in this postpartum period and beyond. It is so important to have an established relationship with your primary care provider during this time period for many reasons. Whether it is late-onset postpartum depression/anxiety, tension headaches, sore throats, anemia, thyroid changes, constipation, weight gain or loss, your PCP can help! Many of my patients have come in either for themselves or their baby’s well child visits, and we discover that there is a problem that needs worked on. It is great to be able to ask “is it normal?” questions to someone that you trust—and get some real and helpful answers. It is great to be able to ask if it is ok to take ______ supplement of medication when you are breastfeeding. It is wonderful to be able to get a referral to physical therapy when you need it. Not losing weight like you want to? We can help with safe weight loss and guidance on nutrition and exercise during this time period. There are so many reasons to have an established relationship with your primary care provider. At IFM, we love caring for whole families: mom, dad, babies, siblings, and beyond! When we get to know you and your family, understanding the dynamic helps us be able to “customize” your care. We do not like putting people on algorithms or in boxes! We do things differently here and are so happy to include you and your family in our care! Our recent addition of lactation services, provides yet another way for IFM to reach the needs of postpartum mothers in that fourth trimester. Check out our website for more information on group lactation classes or private consultations with Crystel Corbin, RN, IBCLC. Sarah LeeARNP, Co-Founder of IFM The season of giving is here. Many of us are wondering what to give our kids. Or if you are like me, what are we going to give them that they will actually play with and possibly learn something from? Well I have compiled a list of what I believe are the top 10 developmental toys perfect for infants and toddlers.
This list covers most bases when it comes to toys, but I would like to add that books make great gifts and encourage language development. Also my favorite gifts to give are experiences, for me creating long lasting memories with my loved ones is what the holidays are all about. So experiences that I can join them on are always my go to gift. Whatever you celebrate, and whatever you choose to give, I hope you have a very happy holiday season! Please stay posted, as Sensory Classes will resume next month. Stephanie, Pediatric Sensory Specialist The amount of information out in the world today about health and wellness can be overwhelming for many of us. It’s tough to know who to trust with so many contradictory reports and opinions. We hear conflicting messages about what matters most for optimal health. Check any social media platform, we find many eager to sell the latest recipe, formula or action plan for success, happiness and health. However, amongst the noise, there are incredible people doing incredible work every single day to connect and share with the world all the most effective ways to live in alignment with one’s best self.
One of those incredible people is world renowned brain researcher at Harvard Medical School, Dr. Rudolph Tanzi. I’ll spare you the entire list of his many accomplishments (you can use google), however a few of his accolades include: Co-director for the Center for Brain Health at Massachusetts General Hospital, author of over 500 Research studies, one of Time Magazine’s 100 Most Influential People in the World, and the person credited with discovering the first Alzheimer’s Gene. He’s also the staff Neuroscientist for the New England Patriots. This man is not your Tik Tok spiritual guru. The guy is world class. I was recently listening to a wonderful lecture by Dr. Tanzi, and I’d like to share some takeaways from his presentation. A primary message of the talk was this: Reducing inflammation in the brain and body allows and promotes optimal health. Dr. Tanzi puts it bluntly, “Inflammation is the main killer.” More and more of us experience brain fog, memory impairment, decreased focus and feelings of being less mentally sharp every day. Many of these “symptoms”- dare I say signals- our bodies experience point directly to the complex world of inflammation. Pure and simple, inflammation is bad for our brains, yet many of us take little action to treat our brains with the LOVE and care they deserve. Luckily for us, Dr. Tanzi has powerful suggestions (with plenty of scientific evidence) for anyone, at any age, to take action now to reduce inflammation in the brain and body. The complexity of the inflammatory process is far beyond the scope of this blog, but let’s just surrender to the idea that negative stress within our internal and external environments equals inflammation in humans. Prolonged inflammation equals all kinds of negative health effects on virtually every system of the body. If we can assume this to be true, we want to create a life that aligns with a state of low levels of systemic inflammation. Many behaviors promote decreased levels of inflammation, but to continue borrowing from Dr. Tanzi’s work, he has come up with an acronym to help us remember the most powerful ways we can reduce inflammation in the brain, prevent disease, promote mental agility and become as mentally fit as possible. Think S.H.I.E.L.D when you start thinking about brain health. Sleep, Handle Stress, Interaction, Exercise, Learning New Things, Diet.
“The healthier your gut microbiome is, the healthier your brain is. That’s not woo-woo science anymore. There is hardcore evidence.” “Plant-based fiber is the best thing you can do for your gut and that’s the best thing you can do for your brain.” Powerful statements. I urge you to read them again, write them down and take action to support your brain and body in a more loving and authentically aligned way. In a world constantly trying to sell you the latest and greatest health product, can you find the wisdom in the simplicity of Dr. Tanzi’s S.H.I.E.L.D approach. Give it a shot. What’s one small step you can take today to inject fresh energy into each category/letter? If you’re needing help getting your health on track, check out our website to schedule an appointment with an available family practice or mental health provider. https://www.integrativemediowa.com Dr Justin Janss, DNP, ARNP, PMHNP-BC |
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