333: Empowering Health through Lifestyle Medicine: Christina's Journey in Preventive Care

00:00:00 Christina: We're a fiber deficient country. Most people don't get as much fiber as they need, and so I was also not getting enough fiber. And now because I am getting all that fiber, it's definitely better. And the other thing you mentioned, the gut health mental combination there. The vast majority of the serotonin that is released, created in our body is actually from our gut microbiome.  

00:00:26 Maya: And so when we can improve that with a whole food plant based diet, we can significantly increase our serotonin levels, which can are shown to help with mental health as well. This is the Healthy Lifestyle Solutions Podcast, and I'm your host, Maya Acosta. If you're willing to go with me, together we can discover how simple lifestyle choices can help improve our quality of life and increase our longevity in a good way. Let's get started. All right, friends.      

00:00:57 Maya: Welcome back to another episode of the Healthy Lifestyle Solutions podcast. I'm your host, Maya Acosta. Today, I have Christina Lascano. She went into healthcare due to her passion for preventative and lifestyle medicine. She graduated from Texas A&M University with honors in 2014 with a degree in Allied Health. And then she went to PA School. That's physician assistant at the University of North Texas Health Science in Fort Worth and graduated in 2017. Since completing her schooling in PA, Christina has gained experience in primary care, urgent care, and lifestyle medicine, which we love here on the show. And she joined the American College of Lifestyle Medicine in 2019 and is in pursuit of her ACLM Certification this fall. That means that she'll be board certified in lifestyle medicine.     

00:01:56 Maya: I believe so. We'll talk about that. And also within her practices, she focuses on cooperating lifestyle modifications as a first line approach to many chronic diseases. She enjoys teaming up with patients to help them realize and meet their health goals. And I'm most excited about this part, too. She joined Mora Medical. You remember Dr. Lori Marvis was on the show speaking about her practice, Mora Medical, so Christina is part of it, and she joined in October of 2022. Christina also was invited to speak at one of our events in the fall, where she spoke about what they do at Mora Medical. And she has loved working for this company and shares her passion for lifestyle medicine.      

00:02:42 Maya: Christina also lives in Dallas, which is so exciting, and it's one reason that I'm getting to know her. She's with her husband, Christopher. Outside of work, she loves going for walks, exercising, doing yoga, journaling, meditation, and traveling, of course, trying out new foods and spending time with her family and friends.

00:03:04 Maya: Welcome, Christina.       

00:03:06 Christina: Yes, Thank you so much Maya for having me. It's an honor truly to be on your podcast. Thank you–

00:03:13 Maya: Thank you. Yes, and I'm so glad that you also came on board. And the more that I get to know you, the more excited I get about our connection and possibilities for how we can collaborate and support people in the community. So I did mention that you're in Dallas, so I want to kind of remind people briefly of how you came to our event in the fall. That was with Dr. Will Tuttle, who was in town on tour promoting his World Peace Diet book. And at that time, we partnered with Mega Shaw from True V, and that's where we held the event.  And then you had a few minutes to talk a little bit about Mora Medical. So that was pretty cool that you came. 

00:03:54 C:Yeah, I loved coming to that event and meeting all of your followers and then also some of your friends in the plant based community of Dallas and Fort Worth.

00:04:04 Maya: Yeah, I feel like the community is starved for these kinds of events. We need more of this stuff. So a little bit later, we'll talk about some things that you and I are planning to do to support the community. Christina, let's start with your health story I mentioned before we started recording. People love to hear these stories because most of us have had some sort of ailment. I often talk about how before I became whole food plant based, I suffered from menstrual cramps and I had acne and extreme fatigue. There was so much that was going on with me, and today I have more energy and I feel better. But people come on the show and they share all sorts of stories about what they experienced before they adopted this way of life. So tell us what was going on with you. 

00:04:56 Christina: And I love sharing my story, and I'm so glad I'm going to be able to share that with your followers. I graduated PA school in 2014, and then it wasn't until about 2019 that I kind of started looking into lifestyle medicine. But what was going on was I've always had some GI issues. I realized in high school that I was lactose intolerant, so I stopped drinking milk products and dairy products, but I still was having some problems and didn't really know what it was. I grew up in a family where my parents were very good inspiration and role models for us. We ate healthy and we moved our bodies regularly. We were in sports and things like that. But there was always this like I felt like I couldn't digest certain foods. My stomach would be upset after I would eat. Having a lot of bloating gas constipation to not put it lightly. Those are the symptoms I was experiencing.    

00:06:06 Christina: And it wasn't until I started practicing as a PA, I've always been passionate about preventative medicine, and that's what I called it until I found lifestyle medicine. I was always passionate about helping people to prevent chronic disease, prevent worsening of their chronic disease, prevent progression. Right. But in 2019, I found American College of Lifestyle Medicine and Dr. Dean Ornish's work because I was researching ways that I could improve my own health. I was researching things that I could do to improve my intestinal problems that I was experiencing. And I stumbled across Dr. Dean Ornish's work. He was the first one that I found, and it was eye opening for me. I was like, oh, my gosh, where has this been? Like, my whole life? And also since I've been a PA, I didn't really learn about this in PA school, and this is so exciting. And I just dove in and have been learning more and more since. But basically what I did was I started to incorporate more plant based meals into my lifestyle. So my husband was luckily on board, and we started with just one meal a week.

00:07:23 Christina: We did more food plant based once a week. I think it was Meatless Mondays, we called it to start out. And then over time, I kind of worked up to it. Over time, my stomach issues got better. I started having less bloating, less constipation, less just upset stomach, and I started to feel a lot better too. I had more energy. I was struggling with some burnout and some mental health as well, some depression at that time. And so that also improved. And so it was amazing how many things were improving in my life. My husband was also feeling better, and over about a year or so, it went from Meatless Mondays to meatless every day.  And we went whole food plant based. And the meal we learned how to cook these foods. We learned how to order certain things when you would go eat out, and it was fantastic. We were like, oh, my gosh, this food is so delicious. And honestly, I liked it even better than I liked what I was cooking before. I just didn't know about it.      

00:08:31 Christina: And a little side note they’re my family. Growing up, we thought we just couldn't digest beans and legumes. We just thought our stomachs, they just didn't sit well with us. But over time, I had to work up to eating the beans because I wasn't used to eating them previously. But I actually started out with just one tablespoon of beans a day, and then I would work my way up, and that worked for me. And I tell my patients that too. A lot of times, if you're not used to eating these things, it takes some time for our gut microbiome to adjust. And once it does though, you're able to digest these foods without any problem. Now I can eat half a cup of beans, half a can of beans and have no problem. So my stomach is better, my intestines are better, I feel better and I just love to share this with my patients as well. Like I said, not only did my physical health get better, but also did my mental health.

00:09:57 Christina: I think for me it was the non starchy vegetables and the legumes. Those would be like the two things that I didn't have enough of in my diet. Especially when the standard American diet, a lot of times it's like what's for dinner and chicken and then the vegetables. Like a side thought, right? Oh well, I guess we'll make this vegetable that we have. So incorporating my meals were so much more colorful. There were so many more vegetables incorporating lentils, which I'd never really eaten before, different types of beans I mean, I learned so much like that year. And yeah, I'd say the biggest thing I was lacking was the fiber just from all the vegetables and the beans. We're a fiber deficient country. Most people don't get as much fiber as they need. And so I was also not getting enough fiber. And now because I am getting all that fiber, it's definitely better. And the other thing you mentioned, the gut health mental combination there, the vast majority of the serotonin that is released, created in our body is actually from our gut microbiome. And so when we can improve that with a whole food plant based diet, we can significantly increase our serotonin levels, which can are shown to help with mental health as well. 

00:11:23 Maya: That is probably why we have this wonderful overall sense of well being when we clean up our diet. Because not only are we not feeling the physical symptoms of being weighted heavy, like the foods that are deep fried and processed kind of have this heaviness on us. So you feel lighter when you're eating more salads and bringing in more vegetables into your diet. But also you do feel like I noticed that my anxiety, my overall symptoms when it came to feeling anxious, improved as a result of cleaning up my diet. I also like how you talked about how you took your time and you added foods gradually and over a course of a year, you and your husband did this together and you probably hear this all the time, also working with patients. So you probably just hear this from other people that when people decide to make this change and they're not prepared and they do it overnight, that sometimes can be sort of not the best approach because it's not going to be a sustainable change that they'll make. 

00:12:34 Maya: I may have shared with you, I think over dinner. I shared with you that there was someone, an influencer that I learned from who was fully raw.  And I was raw till four, meaning that I would have the papayas and the mangoes and all these healthy, mainly fruits in the morning. But my belly was distended, I was gassy, I was uncomfortable, and no one told me, hey, incorporate a little bit at a time. Your body's not used to having all of this all at one time. And instead I was like, it doesn't work for me. I'm just not going to do this anymore. But now I don't deal with any of that at all. I have beans regularly. I have other foods that people may say can be discomforting from time to time, and I actually feel really good. But now it's been seven years as well. 

00:13:27 Christina: That's a common thing that we help our patients with at Mora Medical is when they transition to a whole food plant based diet.  A lot of people will have some GI discomfort or sometimes even some other symptoms can happen when your body is kind of adjusting, even seeing people with mild headaches and different things like that. So as somebody's adjusting to a whole food, plant based diet, having some guidance can be helpful. I didn't have any guidance, really, besides just my research that I was doing. But yeah, I usually tell people, some people can just go 100% whole food plant based overnight, and they do okay, say the vast majority of people have to kind of work their way up. I don't think it necessarily takes a year like I did. I think you can do it much quicker than that, just fine. And that's what I like to help my patients with for sure. 

00:14:25 Maya: Speaking of you working with patients, can you explain to my listeners what a physician assistant is and does? How is that different, say, from a nurse practitioner or just a physician in general? 

00:14:39 Christina: Yeah, that's a great question. So a physician assistant is very similar to a nurse practitioner. We basically function the same in primary care, in most specialties, same thing with in lifestyle medicine. Basically in essence, we do the same thing. We're able to see patients on our own individually. We're able to prescribe medications, we're able to decrease medications, which is what I like to do. If possible. We're able to provide medical advice and care as well. It just needs to be under the direction or the supervision of a physician. So as a PA in Texas, each state has different rules. But as in Texas, we meet with our physician once a month to review cases and to discuss patients and then also discuss questions and things like that. And then the physician is always available for any questions that we have at any time, not just once a month. So they're there for us if we have any questions. But like I said, it's very similar to a nurse practitioner. In some states, nurse practitioners are able to practice without any supervision from a physician. That's one little difference that's starting to change. Physicians still need to have the supervising physician.

0016:06 Maya: Riz, as you know has his vascular practice, his vascular center, and he has a nurse practitioner that's working there at the center. While Riz still has he's still working at two other hospitals. And so it just alleviates a lot of the burden that Riz would have in terms of assessing patients and working with them. I hear all these stories all the time, so I know that he's very happy with his nurse practitioner being available and being very reliable in the center. So now I remember when we were having dinner, you shared with me a little bit about what life was like as a physician assistant, working in kind of the regular Western medicine model, regular practice like that, and what it's been like now that you've learned about really a field that you were already interested in in terms of preventative medicine? But it's more lifestyle medicine and working with more a medical. How has that changed how you work with patients?

00:17:09 Christina: That's a fantastic question. So I would say it's changed pretty significantly. So in primary care, as I mentioned, I'm very passionate about lifestyle medicine and preventative medicine. I was always very cognizant of taking extra time with my patients to talk to them about all of those things, about all the six pillars right. That we talk about all the time. And I would take time. I actually would use my 15 minutes that I had with the patient and make sure I had some time to talk about one of those pillars at least, that maybe could help them with a number of their chronic conditions. Now with Mora Medical, I have a little bit more time with each patient, which is fantastic because I'm able to spend even more time to get into the nitty gritty of okay, are you moving your body? Tell me more about your diet. Can send me your food log. Let's go through that. How about your sleep? Are you sleeping well? How many hours are you sleeping? Right? So I have more time to spend with the patients. And also they're interested, too, in making some lifestyle changes.

00:18:20 Christina: They usually come to us because they have some interest in making some change as well. So that would be the biggest thing that's changed. The other big thing that's changed is that at Mora Medical, we do group medical visits. So I do a combination of one on ones and then also group medical visits. And the groups are so wonderful because the patients come and they get to know each other and they support each other. When somebody says, oh, I've lost five pounds and my blood pressure is improving, other patients are on there clapping and giving them kudos. So there's a community that develops there. The patients develop, they find a community. And I think you mentioned earlier, even today, being out in the world, right, in America, it's hard sometimes as somebody who eats plant based, most people around us are not eating plant based. So when we find this community, it can be so helpful to basically help people to maintain the lifestyle changes that they're wanting to make. Because it can be lonely when you do it on your own and be harder to stick to. But when you have an accountability partner or a group to come to each week that you know everybody there is also going to be on the same journey or a similar journey, it can be so much easier to make those changes that are necessary to see the health benefits that you want to see. 

00:20:01 Maya: Yeah, absolutely. It's a lifestyle change. And I like the word like a support group. I like the idea of that being like a support group, a community that we join for that support. And if you think about it because. I do too much thinking, but if you think about it, like how we live before we come to lifestyle medicine, the people we surround ourselves by already reinforce a certain lifestyle. So if we enjoy eating popcorn or whatever it may be, if we love doing restaurant tours, whatever it may be, whatever lifestyle and hobby that we're interested in, we find like minded people to join us in that. If we like drinking and going to bars or partying, we find people to join us in that. When we decide to make healthier choices, we have to find the community so that we can do it together. So it doesn't just become about the food, but it becomes about enjoying someone's company who also shares similar values when it comes to eating a little bit cleaner, for example. So it's kind of like having to start over in some ways. I don't have in my immediate family, anyone, really, that's on board with the choices that I made in terms of lifestyle modifications.   

00:21:19 Maya: So it's always nice to come together with other people that do value that, where I don't have to explain or justify or defend myself for making these healthy choices. There was something else that you said about having time. And I remember I had a dietitian on the show once who went and saw a patient. She was sent to speak to this patient because she's bilingual, fluent in Spanish, and she walked into the hospital room and the whole family was there and she said, okay, who's the patient? Okay. Type two diabetes is what they were battling with. And so the individual, the dietitian said, have you ever been given diabetes education? And they said no. They just know that the patient has type two diabetes but doesn't know the details. They didn't know how lifestyle affects the situation. 

00:22:13 Maya: So that's what you're talking about is that many times when we're in the regular system and we're only given 15 minutes a year, or whatever it may be with our doctor. The doctor first of all, may not be equipped and trained in knowing that lifestyle modifications can actually help improve a condition. But they might actually not know what to prescribe in terms of food and lifestyle. And so this is what you and Mora Medical are doing, is that you're helping to inform people that it's not even just what you eat, but it's also whether you're getting quality sleep, whether you're moving. Because in our society, we just always believe that you should restrict what you eat and exercise more. Which just frustrates me when I hear that because exercising almost feels like you have to be at the gym all the time. And our goal is to encourage people just to be more active, just to get out and walk and be active in their community. 

00:23:16 Christina: We at Mora Medical try to avoid the word exercise just because it can be triggering for all of us, I think. Right. So I love the word physical activity or movement.         

And my tip to my patients is always find something that you really enjoy doing. Find something that brings you joy when you do it and that you can look forward to doing. So like, for instance, I used to run, I used to be a runner. And I really didn't enjoy it. I don't know why I had this identity. My friends would always get together, oh how are you doing? Good. What runs are you doing? They would ask me about it and it was almost like part of my identity that I was a runner because I did track, but I didn't really enjoy it. 

00:24:08 Christina: And it wasn't until I found other exercises and other ways to move my body that I really enjoyed that I started to really look forward to movement.  I looked forward to that time that I had carved out. And so I always just encourage people. If this type of movement isn't working for you, if you're dreading it, experiment. Try some new things. Try water aerobics, try pickleball. Right? That's the big thing right now. Try something new. And then also when you figure out if you like to work out by yourself, do you like to work out in a group, experiment with different options and find something that brings you joy because that's what's going to be the most sustainable.

00:24:54 Maya: Absolutely. I've never liked going to the gym, and I'm almost embarrassed to say that because that's not necessarily but just when you said that the word exercise can be triggering. And I try to be careful also about words that I use because I also don't want to encourage people to restrict their eating or feel deprived. But I've always said, get me outdoors and I will be active. I love being outdoors, I love to cycle, everything. So I might have shared with you that Riz and I were going on a hike to Caprock Canyon, and I don't know how much I shared, but I never realized how much I love hiking. And it just could be that again, I wasn't surrounded by people who did hike, so I wasn't really invited. But some friends, two of us that are couples went to Caprock for, I don't know, three days or so. But it had been raining, it was slippery. So what would have been like six hour hike? No, not a six hour, but a six mile hike that we should have completed supposedly around 4 hours or so. It took us 7 hours[crosstalk] because it was slippery and wet and all this, I felt so good. There would be times where I would climb up the rocks and just barely be able to catch my breath. And then we're working, walking a little bit flatter on a flatter surface and I would feel good and then we would do that again.

00:26:20 Maya: And I'm telling you, Christina, I loved it. I loved it so much. And so a friend of ours is doing a hike in an evening hike tonight. I've never been to this particular place not far by, I think, Plano or something. So I I'm going, because she hikes all the time. And I've been telling her, I want to tag along. But it's community, it's doing something fun together, it's challenging yourself to see if you can do it, if it's too difficult. There are different levels of hiking. You can do basic something that's easier until you can work yourself up. So yeah, I too love all of that. So tell us more about Mora Medical. What else do you do to support patients? 

00:27:08 Christina: So at Mora Medical we are all remote. So we do everything through telehealth, lifestyle, medicine, practice. We are not primary care. We encourage all of our patients to have a primary care doctor in addition to seeing us. But we help people to make all of the lifestyle changes that we've been talking about. So as I mentioned, we see people on one on one visits and in groups. The majority of our practice is really built on those group medical visits. And as I mentioned, there's a lot of benefit to the group. There's evidence that it can be beneficial for behavior change.   And so that's one of the reasons why we do it that way. And as I mentioned, we talk about not only diet, so we don't only talk about whole food plant based eating, but we also talk about the other six or the other five pillars. So of course we have eating whole food plant based, moving our bodies more, improving our sleep and getting more restorative sleep. That's a huge one, I would say. I'll come back to that one.       

00:28:19 Christina: Reducing stress, which is another important, reducing use of harmful substances like alcohol, tobacco, and then that social connection. So the social connection you mentioned a couple of times, having that community, having those people that you connect with, people that you have something in common with that's so important for our overall health. And so just by doing it in a group setting, we're helping with that one pillar. We also have each of our groups. Each group has a WhatsApp group that they can connect with outside of the circle so they can talk throughout the week.  We also have a private Facebook community where people can post their recipes like questions. They have various things of that nature. 

00:29:06 Christina: And I want to go back to sleep, though really quick, because that's a big one that we talk about at Mora. So sometimes when a patient will come to us, they will want to change certain things, but they're not getting enough sleep. And so they're just really fatigued. They don't have the energy to get out and cook a meal. They don't have the energy to exercise or move their bodies, right? And so sometimes sleep is one of the first things that I work on with a patient if they're really struggling with their sleep, because once we get that better control, once we get somebody sleeping better, their energy goes up, then they have more energy to make some of the other lifestyle changes. So sleep is super important and a lot of people don't realize, right? And I don't think I always realized either until I started doing this research and joining this company. So that's a little bit about what we do.         

00:30:08 Maya: I love the idea of encouraging people to get appropriate, adequate sleep, because it wasn't until I learned about lifestyle medicine that I really began to see the connection between my quality of sleep and what I crave. It's not just energy. It's not just not having enough energy. If I'm not well rested, it affects my mental capacity. So I can't remember I'm not as sharp. My mind is not functioning fully the way that I'm used to functioning when I have adequate sleep. So that's one thing. But then, Yes I've noticed that if I don't get enough sleep, I crave the processed foods, the salty foods, the comforting foods. And I don't know why that is. Do you have any idea? I go back to it affects somehow our gut health, but I see why you would want to tackle that and encourage people and support them in getting adequate sleep so that they can also then combine that with eating more fruits and vegetables for example. 

00:31:16 Christina: So there's actually some physiology behind why when we don't get restful sleep, why that can interfere with our health. So a couple different things there one is that there's a hormone called leptin that helps control our appetite and our hunger. And so when it's secreted while we're asleep, and so when we don't get enough sleep, that hormone isn't released as much. Therefore our appetite increases during the day. So that's a lot of times why we will crave these things. Like you mentioned, when we don't get enough sleep. Another piece to that is that when we sleep. There's a lot of DNA repair and modeling that can happen. So if we don't have restful sleep, that can increase inflammation in the body.  And of course, as we know, inflammation can increase risk of a number of chronic conditions. Not getting enough sleep can also impair our mood, so it can make us more irritable and it can also affect our concentration, making us have more difficulty focusing on tasks and also being able to control our ups and downs. So there is a lot of evidence behind that. And so that's one of the reasons why we talk about sleep so much. 

00:32:38 Maya: It's such an important topic. And all of it, the whole field of lifestyle medicine, the pillars, all really affect one another. When I decided to stop drinking alcohol, which was mainly wine, it was only Lifestyle Medicine that brought this awareness that no amount, and I talk about it on the podcast, so no amount of alcohol is safe. But I began to notice once I stopped drinking that I was sleeping better. So the waking up in the middle of the night was being caused by wine, by the fact that I was drinking wine. And my anxiety, I was having a glass of wine to relax, but it actually was adding to my anxiety. And these things you don't know until you begin to make those changes. And like that expression that you never knew how bad you felt until you felt better or something like that. That's kind of like what I too began to see with lifestyle medicine. And then I often say that I feel very lucky that as a Podcaster I get to have all these conversations that help educate me. So then I implement these changes too.     

00:33:54 Maya: And so speaking of sort of remote learning, in a sense, I want to emphasize again what telemedicine is because I've been wanting to encourage my listeners to take a chance and really explore having support via telemedicine. I know that what you said earlier was that you don't discourage people from moving away from their primary care physician, you want to work kind of in collaboration with the physician. So tell us how Mora Medical works with patients.

00:34:26 Christina: Everything we do is virtual. So we use telehealth as our platform, we use Zoom actually as our platform, but everything's through telehealth, which is actually nice for patients, especially because we do meet with our patients more frequently. We meet in the group setting every week for an hour. And so patients aren't having to commute a long way to get to a doctor's appointment. They can do it from the comfort of their home. Some people will join during their lunch break at work, or they'll do it right outside their office before work, different things, so that it can fit into their busy schedules. And that's one of the real nice benefits of it being telehealth. Another really nice benefit is that I can be here in Texas, but I can be seeing a patient because I'm licensed in multiple states, and so are our other providers. We can see patients that are in other states. Even so, I can see people in California and Florida and New York and otherwise, without this amazing technology, we wouldn't be able to do that. So we have much farther reach. 

00:35:34 Christina: We can help more people in that way, and then we help by connecting with their primary care. So we provide every patient with a letter to give their primary care doctors, telling them what we do, who we are, how to contact us if they have questions. And then we're also starting to actually send our notes to providers as well, so that they're going to be getting notes on their patients. And so we like to communicate with the primary care doctors if we can. And so that's why we do encourage patients to have a primary care doctor, because there are certain things that we can't do virtually. It's ideal that you could have your heart listened to once a year, have your lungs listened to if you get a cold. You have to have somebody listen to you and look in your ears and all of those things. And we don't order colonoscopies or mammograms and screenings like that, so that has to come from the primary care. But there's a lot of things that we can do. We can order labs for patients. Some people like to have their primary care order the labs instead, or we can order them, and then we can set up a one on one to review those labs.

00:36:56 Christina: We can also decrease medications or increase, if we need to, certain things like diabetes medications and blood pressure medications. Those are the two most common that we adjust. And that's because a lot of times when somebody does go whole food plant based, their blood sugars and blood pressures will come down fairly quickly, which is what we want. So then we have to adjust the blood pressure medication, adjust the diabetes medication, just because it's a risk. It could be life threatening. Right. If somebody's blood sugar comes down too low or their blood pressure is too low. So we decrease the medications to keep their levels where we want them. 

00:37:41 Maya: Even physical activity, just moving regularly can help improve blood sugar and blood pressure as well. Right. So even that can be a reason why they might need to be de-prescribed.

00:37:53 Christina: Exactly. We have a lot of patients use the continuous glucose monitors that go on the back of your arm or your stomach. There's a couple of different kinds.         

And yes, it's so fun helping patients with all of my patients, but the ones that have the CGMs, they learn a lot from it. And I've had patients say, oh, if I eat my greens first, I eat my non starchy vegetables, then my blood sugar, and then I eat my greens or my grains and my beans, my blood sugar won't go up as high even if I had the same exact meal. If I eat the greens first, blood sugar doesn't go up. I've had that with a number of patients have told me that. And then another thing, this isn't just from patients. This is also from evidence. But 30 minutes after you eat, going for a quick walk, it can even just be ten minutes, 20 minutes, but that can bring down your blood sugar as well. So there's lots of different things that can affect our sugar levels, and then stress can increase it, right? So that's why we talk about stress reduction.

00:38:58 Maya: Yes, I was listening to another podcast because I listened to podcasts like crazy. And there was this woman who was sharing her story of how she went through a pregnancy with preeclampsia and so much so that she had a bed ridden. And she talked about how they kind of darkened the room and turned down the sound to keep it very quiet. And so the podcaster asked, why is that? Why did they do that? And she said, well, light and sound can actually affect the blood pressure. You just never know. And I imagine that if you're like high anxiety acid is, and you have blood pressure issues, that a lot of lighting, a lot of things that can stimulate you, probably contribute to also increasing your blood pressure. I don't know, that's the impression that I got. 

00:39:46 Christina: There's a lot of things that also can affect your blood pressure as well. So we talk to our patients about those kinds of things. And a lot of people don't realize that when you exercise, your blood pressure does actually naturally go up right, to accommodate for the exercise. But then it comes down after you exercise. So just it's up while you're exercising or while you're moving your body. But then the rest of the day, usually once you get into a routine of moving your body regularly, blood pressure can come down pretty significantly. 

00:40:20 Maya: Yeah, that's awesome. So now, as you probably know, Dr. Marvis was on the show, and she talked a little bit about what these shared medical appointments look like, or at least the different programs that are available, depending on what the patient is looking for. I want to say that she mentioned one that is intended for weight loss, so if patients are interested in that, they can sign up for that and you could tell me more. But I think the other one was on disease reversal, and I'm not sure if the other one was on just adopting a whole food plant based diet, like how to get started. So can you tell us more about those? If I'm correct, I don't know. 

00:41:01 Christina: Yeah, that's correct. So we have three different types. One is for our patients that are already eating plant based that want to further optimize their health. So we have a number of patients that maybe they've adopted a whole food plant based diet, or maybe they've adopted mostly plant based diet, but they're still maybe 70, 80%, maybe 90% there, and they're still having some other chronic condition, maybe high blood pressure, high cholesterol, osteoporosis, postmenopausal symptoms of maybe insomnia, right?       

So variety of different conditions that they might still be wanting to improve or optimize. Some come to us without any chronic conditions, and they just want to optimize their health. And so that's one group that we have, one set of groups, so we call those our plant based circles, even though all of our circles are technically plant based circles, because we're promoting plant based diet. Those are our ones where patients come to us already mostly plant based.

00:42:13 Christina: The second type is the weight loss specific circle. So that one is for patients that want to lose weight. We have a large number of patients come to us wanting to lose weight, and so we decided to create one that was specifically for that. The nice thing there is that everybody in the group wants to lose weight. And so everybody has that shared connection for wanting to improve their health through weight loss. And most of them also have maybe one or two other conditions, maybe more, that they're also trying to improve.  And with the weight loss, things like diabetes and blood pressure tend to also improve. And some of the same things that you do for the weight loss also help with the other chronic conditions.

00:43:01 Christina: And then our last type of group is the disease reversal group. So, as I mentioned, some of the people in our weight loss group do also want to reverse a disease as well. But the disease reversal is really those patients that are focused mostly on reversing their chronic condition. So maybe it's diabetes, maybe it's high blood pressure, high cholesterol. Those are probably the most, three most common. But we also have a lot of patients with autoimmune conditions, various kinds, Psoriasis or Lupus or Multiple Sclerosis, different things like that. Then they're wanting to improve either their pain, their symptoms. And then we have patients, too, with Osteoporosis and just a big variety of different chronic conditions that they're trying to improve. And so in those circles, we will ask about how is your blood pressure, how is your blood sugar? And I always am very respectful and try to say, okay, is it okay if we talk about your vitals in the group setting? And they say, almost always say yes, and then we will talk about it. And then I can adjust their medication if need be.

00:44:25 Christina: So those are the three main kinds. And then, as I said, we do also do some one on ones, but those are usually for our patients that are in circles. We call our group medical visit circles. I don't know if I mentioned that. 

00:44:38 Maya: I kind of put two and two together. I was actually going to ask you to clarify that. So your shared medical appointments are called circles.

00:44:46 Christina: We like to think of it as being like a circle. Right. So we're all connected. And so that's one of the reasons why we keep calling circles.

00:44:57 Maya: And it feels like community because I right away imagine people in a circle holding hands, supporting one another-- So I want to touch a little bit on two of the circles that you have. The weight loss, I am happy that you have that because I might have told you this in person, but for me, I'm very passionate about supporting people in weight loss. Now, I don't do any of the coaching or anything myself, but through the podcast and being gentle with that topic in the past, I've had an obesity medicine specialist come on the show because I feel that that's one area that many primary care physicians are not well trained in. And supporting their patients to lose weight and knowing how to speak with their patients so that the patient doesn't feel judged by the physician. So I'm glad that you guys offer that and same thing. So just like in any other community you're talking about, these individuals that are seeking weight loss are in the same circle.       

00:45:55 Maya: So they're all seeing results together, which is really encouraging. So I like that. And then disease reversal. When you touched on autoimmune conditions, I thought it was great. I think that's awesome that you mentioned it, because I see often in our Facebook group or people reach out and ask us about specialists that are plant based trained specialists. So Rheumatologists, or just experts trained in autoimmune diseases. And knowing how to treat a patient that has, for example, Lupus, like you said, or multiple sclerosis, those can be very tricky. And your primary care physician may not even know where to start. They might have to actually send you off to someone else.

00:46:40 Maya: So Mora Medical is meeting the needs of these kind of needs that people in our community need but may not know where to start. Like, where do you go? So let's talk about why that is important, to kind of get people to see how telemedicine can support them. You talked about how the meetings are done via Zoom. I have had a life coach that's been working with me for two years, Christina by Zoom. Two years. And we meet every well, it's usually Thursdays, like today. In a couple of hours, I meet with her, but we meet once a week. And we've been doing this for two years. And she has really gotten me through some difficult times because she really teaches me about mindfulness and breathing techniques and working with my emotions. And it's like working with a therapist, but in the way that I like. 

00:47:36 Maya: And I've only met her once. Riz and I went to a couple's retreat in California where she lives and I met her in person for the first time ever. And I was like, oh my God, this is what you look like. And it was so wonderful. And then I came back to Dallas and I continue to work with her. And I'm telling you, it doesn't take away it takes nothing from me to sit in front of my computer and meet with someone that is supporting me in my emotional and mental wellness. And so I really want to emphasize what you said earlier, that it's pretty easy. You just log on to Zoom. After you sign up through these programs, you have a patient portal through Mora Medical. And what's the next step like for people to sign up to become a patient or to work with Mora Medical? 

00:48:26 Christina: And I think a couple of things there. So one you mentioned is it easy, right? Yes, it is easy to get on the Zoom calls. The nice thing is that we send a text message with the Zoom link 15 minutes prior to the appointment. It's like an automated message that gets sent to all of our patients 15 minutes before their appointment. So all you have to do if you want to use your phone, is just click the link and it opens. And if you're in a circle, it's the same link every single week. So you don't have to find a new link every week, and it's the same link for all the patients in that circle. So that makes it easy. You just click the link and it opens and you're able to join. There's a host, right? So I would be the host of my circle. And so when you join, you would say, waiting for host to let you in. And then we let our patients all in a few minutes before the circle.  

00:49:32 Christina: If a patient is wanting to get started, what they would do is go on to our website, Mora.com. So M-O-R-A.com. And from there, there's a big blue button at the top where you can just put book an appointment and you click that and it'll ask you a couple of questions if you want to use insurance, because we do accept insurance. That's huge. I don't think we've talked about that a lot of lifestyle medicine or various coaching and different things like that. Sometimes it's cash pay, right? It's out of pocket. Whereas we accept a number of different insurance companies. So on there, you can say book appointment. If you do push the button for insurance, it'll come with a list of different insurances, and you can see if yours is there in your state.

00:50:27 Christina: But then you can also do cash pay as well if you don't want to go through insurance. So you can choose which one or if you just are like, I'm not sure yet, I just want to talk to somebody. There's another button you can press to just say, I just want to schedule a meeting with the intake team. So if you click the insurance or the cash option, it'll ask you a few questions and you just like a couple and then it'll let you schedule an appointment with one of our providers. It's as simple as that. You click it'll, show a screen with the different providers, the times that we're available. You just click a couple of buttons and then you're scheduled if you want to just find out more information. Like I mentioned, there's that third button and then you put in your phone number and email address and then one of our intake MAS will call you and answer your questions. And then if you would like, set you up with a circle or a one on one visit with the physician.

00:51:27 Maya: Awesome. So I was talking to my mom the other day, this is not at all associated with more medical, but the reason I'm going to bring it up is because you never know until you ask. So the other day, I don't live in the same state as my mom, but she was telling me that she woke up with a neck pain. So I suggested she go see a massage therapist or a chiropractor or whatever she's open to. And she said, well, first I'm going to go to my doctor to get a referral. And I said, mom, you don't need a referral for a chiropractor or massage therapist. And she said, oh, but my insurance covers it if it's a referral. Well, she's older, right? She's retired. And I don't know if it's like Medicaid or Medicare, I don't know, I don't know which one she uses. But the whole point is that she said even if she goes to the gym and wants to work with a personal trainer, the insurance company will pay for it. And I said, what, you should be taking advantage of all of that? Like, I had no idea. So I just kind of wanted to throw that out because you never know what your insurance company will cover and how the billing has to be done for that-- 

00:52:36 Christina: I think just being able to accept insurance is so fantastic, right, because as I mentioned, there's a number of other services out there where it's cash pay only and that can be limiting for some patients. And so we really want this to be something that patients can actually do, something that they can feel financially okay doing. And so, always check with your insurance, check with us and our intake team can check with your insurance and make sure that we're on your plan and can tell you how much each visit would cost for you. For some patients with certain insurances, it doesn't cost anything and for some they have to meet their deductible first. So it just depends on the person and the insurance. But our intake team would be able to answer those questions. 

00:53:26 Maya: Well, that's awesome because if the insurance company can cover that, then it's just another way to support your health, one less thing to hold you back. So that's pretty cool. I love that. So I want to mention that you and I are planning an event in July, and I'll mention the date, but if it changes, I'll delete the date from this conversation. But so far we're looking at July 16 in Frisco at the library there, and I'll put information in the show notes. But we're going to do an event where we hope people in the area in Dallas, Plano. Richardson, wherever you are, if you're in Fort Worth, hopefully you can come. 

00:54:07 Maya: We're going to do a combination of showing a documentary like I used to do before the pandemic, because documentaries are so informative, but they also really help sway us. So you can bring a friend, a loved one, who you think may want to hear this message about this one's titled From Food to Freedom. So it's a documentary, kind of like a part two by Nelson Campbell. I often talk about Planture Nation on the podcast and what it means to be a pod leader. And so this documentary came out this year and Dr. Lori Marvis is in it. And so I want to encourage people to come out to the library again. I'll put all the information in the show notes and Christina is going to be there. 

00:54:40 Maya: And so our goal is to help you to inform you in person about a couple of things. You'll see in the documentary that Dr. Marvis worked with a small group of individuals for ten days and that they saw significant changes in their numbers, and then they go off back into their communities, and some of them go back to their old ways of eating. And what we conclude, at least from watching the movie, is that people need support to really have this lifestyle change be permanent. We need support. So whether you find the support by going to a circle on Mora Medical, one of their plant based circles, or whatever works for you, or locally joining one of the events that we do in the Dallas area, whatever support works for you, we want to encourage you to stick with that. But also we want to talk more about telemedicine and what that looks like, especially Dr. Marvis's program or a medical. That's telemedicine. And that's what Christina has been talking to us about today. 

00:55:58 Christina: We're really excited to meet everybody in person, and hopefully you can come and hear or see the showing From Food to Freedom, because it's a fantastic documentary. And as Maya mentioned, the number of the patients had significant improvement in their chronic diseases just within the ten days of the program. So, yeah, I'm excited to watch it again with everybody and then answer questions and talk more about how telemedicine can be helpful. 

00:56:39 Maya: And you know, Christina, I've lived this way with a whole food plant based diet for seven years now. And at least once a year, I watch one of the documentaries. Usually it's Plant Pure Nation or I'll watch what the health of Forks Over Knives?  Again? Like, once a year, I rewatch something I've already watched because it reminds me of why I made these changes, because I know that as I get older, my risk for many conditions goes up. And so I'm helping to prevent health problems that could develop later on by making not only changing and improving how I eat, but also moving, getting enough sleep, all the other things that we talk about in lifestyle medicine. And so I'm excited that we're going to do this in the community. I feel like people want to come together, that they're looking for opportunities.      

00:57:21 Maya: So I'm partnering with another group. We're hoping to maybe combine it with a potluck, but I'm not sure yet. So we're still working on all the details for that. Is there anything else that you'd like to tell my listeners, Christina, about how they can reach out to you if they want to work specifically with you, and any other links that you want to share?

00:57:41 Christina: One thing that I would really like to say is that a lot of times we might know what is important for our health or what we need to do for our health, but it can be hard to make it happen. So at Mora Medical, our goal is to make it easy or easier for you to make it happen. Right? So you might know some of the things that you want to improve. You might know, okay, I want to eat more whole food, plant based, but I don't know how to actually do that. Or I want to move my body more, but I just don't really know what my next step should be. And our goal is to help you make those changes. And like I said, we might know what to do, but sometimes it's hard to actually do it. So we're there to help you along the journey. And if you want to reach out to me personally, I am on LinkedIn. That's probably the best place to find me. And then I am on the Mora Medical website as well. So you can read my bio, look at my information there, and you can schedule an appointment with any one of our amazing clinicians on our website as well.

00:58:57 Maya: Awesome. Well Christina, it's been fun having you on the show. I'm looking forward to doing more with you. And thank you again, because I think my listeners need to hear over and over again what the benefits are of working with someone in telemedicine, and not just telemedicine, but someone trained in lifestyle medicine. So thank you for coming on the show today. 

00:59:20 Maya: You've been listening to the Healthy Lifestyle Solutions Podcast with your host, Maya Acosta. If you've enjoyed this content, please share with one friend who can benefit you can also leave us a five star review at ratethispodcast.com/hls. This helps us to spread our message. As always, thank you for being a listener.