Re-wiring the brain through gratitude


I recently met with a very nice woman who had a very difficult childhood that included physical and sexual abuse.  She was having a hard time shifting her focus away from her past abuses and was struggling with feelings of anxiety and depression.  Unfortunately, this is a very common problem.  You can probably imagine her surprise when I suggested that she focus on the many things that she is grateful for in life.  I’m sure that she initially considered this suggestion to be insensitive.  That is of course, until I explained my rationale. 

Neuroplasticity is the brain’s ability to re-wire.  New research is showing that gratitude can be used as a tool to re-wire your brain circuits to be happier.  Re-wiring the brain is like building a muscle. Just as it takes certain physical exercises to make a particular muscle stronger, it takes certain mental exercises to be happier and more relaxed.  Gratitude is an awesome mental exercise.  Through gratitude, we can re-set our auto-pilot from depressed and anxious to happy and fulfilled 

Robert Emmons and Michael McCollough (2003) conducted a study entitled Counting Blessings versus Burdens. He split up a few groups of people and had one group count 5 blessings per day, one group count 5 burdens per day and one group just write about neutral events. As you may have guessed, the ones who counted blessings, experienced less stress and more feelings associated with well being. 

Counting our blessings is not a miracle cure and most people don’t get immediate results.  Re-wiring the brain takes time. Being thankful is a spiritual discipline and an investment; as the weeks go by, you’ll feel the fruits of your labor.  Our reality is made up of those things on which we choose to focus. 

Thanks for tuning in! 


Uthman Cavallo, MD


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Is there an association between fibromyalgia, chronic fatigue syndrome, and vitamin D deficiency?

I’ve had a few recent patient encounters that have really made me question the cause of chronic fatigue syndrome and fibromyalgia.  These patients carried the above diagnoses and had dramatic relief of their symptoms after treating their vitamin D deficiency.  Do you know anyone who suffers from one of the above mentioned problems?  How about someone who experiences diffuse body pain or chronic exhaustion?  If so, please forward this blog to them.

Chronic fatigue syndrome and fibromyalgia are two disorders that some experts feel may be part of the same syndrome.  They share many features, including fatigue, reduced pain thresholds and depression. Most would agree that fibromyalgia and chronic fatigue syndrome (CFS) are similar, and probably related, disorders.  A practical way to differentiate between the two is that pain is the predominant problem in people with fibromyalgia, whereas fatigue is the major complaint in people with CFS.

A recent study that was published in the journal, Rheumatology, showed that 83% of the participants with fibromyalgia were low in vitamin D.  The subjects who were low in vitamin D reported more pain, depression, and fatigue.  A recent study out of the University of  Minnesota found that 93% of participants who suffered from diffuse muscle and joint pain were deficient in vitamin D.  Symptoms improved with appropriate vitamin D supplementation.  Multiple studies link vitamin D deficiency to chronic aches and pains, fatigue, weakness, and other serious diseases (including cancer).

I’m not sure whether or not vitamin D deficiency is one of the causes chronic fatigue syndrome or fibromyalgia.  But, if I were experiencing the symptoms described above, I would make sure to check my vitamin D level. 

Thanks for tuning in!


Uthman Cavallo, MD

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Is it good to avoid risk?

“Only those who dare to fail greatly can ever achieve greatly.”

— Robert F. Kennedy

Have you ever had a physician encourage you to take more risks?  I happen to think that taking some risk is good for your health.

A few of my colleagues suggested that I was crazy when I first spoke of opening PHA several years ago.  They felt that it was too risky to start a patient centered practice that focused on lifestyle medicine.  Supposedly, other physicians in the area had tried and failed.  I’ve had to deal with the same negative criticism and lack of support that many entrepreneurs have endured.  Short-term thinking and risk aversion dominate this planet. 

One of the essential components of high achievement is a willingness to take healthy risks.  The key to healthy risk-taking is to look for long-term potential gain. An important question is whether or not the short term discomfort is worth success in the long run. The decision to do nothing today means ruling out the possibility of having a big win in the future.  Doing nothing isn’t neutral.  Doing nothing may be extremely negative.

I felt that starting PHA was a healthy risk because the potential benefits to our community far outweighed the risks to my family and me.  What was the risk of starting PHA?  Honestly, not that much.  I could see a drastic drop in my salary (I did).  I could look like a fool because of starting such a new type of practice (who cares?).  I could fail and have to close the practice (not likely).  What would have been the risk of not starting PHA?  Huge!  We wouldn’t have had the opportunity to offer lifestyle medicine to our community. 

I’ve found it helpful to re-define failures and set backs as valuable learning tools.  Think of risks as experiments.  You experiment with a new pursuit, learn from your setbacks, adjust appropriately, and repeat the cycle.   This allows you to plow through your set backs to reach success.  Victory usually follows a series of impediments and is rarely achieved quickly.  My advice:  don’t let the fear of failure get in the way of taking healthy risks.  Playing it safe makes for a very plain and uneventful existence.  Add some adventure to your life by experimenting your way to success. 

Thanks for tuning in!

Dr. C

Uthman Cavallo, MD

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The power of simplicity

The last nine months of my life have been truly amazing.  I went from being a physician within one of the biggest ob/gyn practices in town to opening PHA.  As I look back, I can see that being a partner within a big medical practice came with many strings attached. Life was much more complex and draining.  I found myself doing quite a bit for people who proved not to care much about me.  I also encountered resistance as I tried to mature into a more effective physician.  This meant that I was focusing my attention on what was important to others and devoting less time to what was most important to me.  My life was far from simple!


Believe it or not, now that I’m on my own and taking call 24-7, I’m living a much simpler life.  I sacrificed the comforts of a high salary to become the physician I felt I needed to be, to have a stronger connection with family and friends, and to achieve a healthier balance between work and free time.  Life is so much more fulfilling since I’ve learned to keep it simple and concentrate on what’s important.


Simplicity is the art of focusing on what’s most vital and meaningful.  Instead of paying attention to everything, simplicity is choosing to pay attention only to things that matter most.  Studies have shown that we most value our relationships, our health, our passions, giving of ourselves to others, and living a life with purpose.  People who choose to focus on these things seem to get the most out of life.


Unleashing the power of simplicity requires being able to quickly recognize what’s less important and getting comfortable saying no.  Unless you consciously control your active commitments, they’ll expand until you’re overwhelmed.  It’s tempting to say yes to everything in an effort to be supportive and helpful.  Few of us like the feeling of disappointing others by saying no, but every “good work” is not your “good work” to do!  When you overwhelm yourself with commitments, you take time away from activities that would cultivate a more fruitful and meaningful life.


Based on my experience, I think it all boils down to this: simplify your life by only saying yes to stuff that is vital to your existence and that will matter to you in the long run.  Say yes to things that build your relationships, promote your health and wellness, utilize your gifts and talents, and give you a sense of purpose.  Achieve more by focusing on less.


Thanks for tuning in!


Dr. C

Uthman Cavallo, MD

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Thankful by Choice

I want to make something clear to those that don’t know me well. MY LIFE IS NOT PERFECT. I suffer frequently from depression and anxiety; and I have zero self-esteem. I have recently learned through a very difficult trial that people I thought I could count on for love and support, I could not. My husband and I do fight occasionally. My kids can drive me crazy. I have lost friends that I thought were dependable. My job can be stressful.

Ok, so why am I telling you all this? To try to bring you down? NO.

Here’s why I’m telling you this. BEING THANKFUL IS A CHOICE! I’m grateful for gratitude. I realize that sounds repetitive, but it’s the simple truth. By starting this thankful journal, I’ve learned some pretty valuable lessons about how MANY things I have to be thankful for. It’s a VERY long list. I usually on most days have to narrow by choices down of what to be grateful for. There are a few things I’m grateful for EVERY DAY.

1) my personal relationship with Jesus Christ

2) my best friend and husband Peter. Yes, even when driving me crazy.

3) my two healthy and beautiful girls that never cease to make me smile

4) my parents

5) my brother and his family

6) my job. I love what I do and I believe in the practice where I’m at

7)the coworkers at my job that I can call my friends

8) my health


10) my small, cozy, happy home

11) loyal friends

12) running and biking and triathlons

13) music

14) my church

15) my country

16) my boss, who constantly pushes me to think outside of the box

I’m amazed when I can rattle this list off in just a few moments. I’m so very blessed. I encourage all of you to try, just try, for a day to think constantly of things YOU have to be grateful for.


Krista, Kristy, Kris, Sis, Mommy

Krista Greaves, RDMS, RTV, RT(R)

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Do I need this medication?

Certain medications must be taken to maintain good health.  Type I diabetics require insulin; people with hypothyroidism require thyroid hormone, and so on.  If the body over-produces or under-produces a vital hormone or enzyme, the problem must be corrected.  Safe medications that restore biological balance are good medications.  However, many of us are not on these types of meds. 

A high percentage of medications are prescribed that enable individuals to maintain an unhealthy lifestyle.  For example, studies show that high sugar beverages raise blood pressure.  Some individuals would rather drink pop and take blood pressure pills, than give up their high octane Mountain Dew. Although there are no negative side effects related to giving up sweet beverages, the list of side effects associated with blood pressure medications is quite long.  Just as pop can cause hypertension, stress can cause depression and anxiety.  There are a lot of folks out there who are taking antidepressants so that they can continue living their stressful lives.

I’m not saying that medication can’t be useful. Some conditions cannot be managed without prescription drugs.  However, for most of us who do not suffer from a severe illness, the majority of medications should be used temporarily.  The purpose of taking medication should be to bring symptoms to a tolerable level while adequately addressing the underlying cause(s) of the symptoms.  Medications should rarely be used without natural intervention (sleep, exercise, stress reduction, good nutrition, and so on). 

The consequence of a person relying solely on medication is losing the motivation to find and address the root cause.  For example, strong coffee is a good remedy for fatigue.  Although some may feel that fatigue is caused by caffeine deficiency, there are more plausible explanations.  The temporary energy boost experienced from taking caffeine may decrease one’s motivation for diagnosing the underlying cause of fatigue.  This can make matters worse.  For instance, treating sleep apnea with coffee could be life threatening.

In other words, medication can cover up symptoms, but many do not fix the underlying cause. Conditions such as high blood pressure, high blood sugar, weight gain, depression, and fatigue should all be viewed as potentially reversible. These problems may all result from poor nutrition, high stress, and relative physical inactivity.  Lifestyle medicine is the preferred treatment for these conditions.  This approach decreases the need for long-term use of prescription meds.

If you are currently on a safe medication that addresses the root cause of your ailment, then you probably need to stay on your prescription.  However, if your doctor tells you that the medication is only treating the symptoms of the condition, then maybe it’s time to explore other options.  In conclusion, I would like to answer the title of this blog with a question: Is your medication treating the underlying cause of your problem?

Thanks for tuning in!                                     


Dr. C

Uthman Cavallo, MD

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Eat an early breakfast and small frequent meals. Really?


Eat an early breakfast and small frequent meals.  Really?

Have you ever noticed that we assume that certain things are true if they are stated over and over by “the experts?”  These experts are commonly referred to as “they.”  They say that it’s healthier to eat breakfast within an hour of awakening.  Really?  Does breakfast really boost your metabolism?  Is it truly healthier to have small frequent meals?  I have done my homework and have not found any good scientific evidence to support answering yes to the latter two questions.

As far as I can tell, it doesn’t matter when you ingest your calories during the day. There are certain times when it is more strategic than others, but for the most part, it’s what and how much you eat that’s important.    There is a common held erroneous belief among professionals that skipping a meal will cause one’s body to go into starvation mode.  This is a state of lowered metabolism that is required for survival under extreme circumstances.  This line of thinking is popular among those who recommend eating 6 meals per day.  The truth is that your body won’t shift into starvation mode until it’s been deprived of calories for at least 24 hours.  Moreover, it takes several weeks on an extremely low calorie diet before the body lowers its metabolism.  Skipping meals won’t slow down your metabolism.

I suspect that the breakfast metabolism myth originates from the fact that our metabolism does slow down when we are inactive for long periods of time (such as when we are sleeping).  Therefore our metabolism may be a little slower in the morning as we’re waking up.  And yes, it is true that our metabolism does increase whenever we eat because the body creates heat in order to process the calories we have just eaten. However, while eating temporarily boosts our metabolism, it does nothing to permanently raise our metabolic rate.

I don’t want to imply that eating breakfast and small frequent meals is bad. This plan works well for many people.  It’s just important to know that eating more often does not magically accelerate metabolism.  Eating small frequent meals can work if you have the right portions of carb, fat, fiber, and protein.  And, eating more often can help curb cravings and binge eating.  However, people will do just as well, if not better, if they consume the same number of calories in fewer meals.  There is evidence that we burn more of our own fat when we wait at least five hours between meals. 

I typically eat two meals per day; breakfast around noon and dinner at approximately 6pm.  I do not snack between meals.  I’ve been doing this for about one year and have never felt better.  Some people need to eat breakfast earlier and some need to eat 3 to 4 times per day.  Different strokes for different folks.  We’re all wired a little differently.  What I’ve found is that lean muscle is what really matters when it comes to metabolism.  The more lean muscle you have, the more calories you burn throughout the day.  In short, it’s most important to focus on what you’re eating rather than when you’re eating it.  And, if you want to raise your metabolism, engage in exercises that build lean muscle.

Thanks for tuning in!


Uthman Cavallo, MD

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