Concussions and the healthy brain

In the last couple of years, there has been much discussion in the news about concussions and other brain injuries. In fact, the concussion rate in high-school athletics has more than doubled over the past seven years. Some of this upward movement in the numbers reflects increased awareness of the problem, but some is due to the increasing violence of sports at the high-school level (reflecting an earlier increase in violence in professional sports). We cannot let this get into sports at even younger ages!!

 

And it’s not just football. If you watched any of the World Cup, you know that soccer players are vulnerable to head injuries also!

 

A concussive injury to the brain produces a “transient” loss of brain function. Most concussions feature and are diagnosed by dizziness, lightheadedness, confusion, headaches, and visual changes. Imaging of the brain at the hospital usually reveals nothing. Younger athletes take longer to recover than older athletes.

 

Medical treatment for post-concussion symptoms has consisted mainly of opiates for headaches, antidepressants (God forbid!), anti-nauseas, anti-vertigo, stimulants, and other medications to increase neurotransmitter levels. But research has shown that Glycerophosphocholine (GPC) should be looked at as a valuable tool. GPC is a form of choline that has been shown to protect and repair damaged brain cells. It supports the brain’s ability to recover after traumatic brain injuries  and to reduce the symptoms associated with concussion and post-concussion syndrome.

 

The traumatic forces involved in concussion and in those with post-concussion syndrome have been shown to result in a decrease of glucose use by the brain, and changes in cerebral blood flow. GPC has been used to help prevent damage to brain cells after blood flow (and thus oxygen) has been cut off to brain cells. One study showed that patients who suffered from concussions and cerebral contusions and who were given GPC for a three month period had improved mental faculties and function at a 96% level over those who were not given GPC, but who received “normal” medical treatment.

 

Research done by Paris Kidd, PhD has shown that Phosphatidyl Serine and Acetylized L-Carnitine also are important for brain health. Together, these three ingredients are truly “brain food,” for treating the injured brain and for maintaining brain health. Designs for Health combined the three ingredients into a formula named Brain Vitale.

 

If I were a parent or coach of athletes (professionals and younger) who were subject to head injuries I would advise my players to take Brain Vitale as a preventive for brain injury during the season when damaging contact is likely to occur. I also would keep a supply on hand to increase the dosage when and if there is a brain injury such as concussion. Yes, this will cost a few dollars, but what is the cost of a brain injury? (This is the same supplement I recommend for the problems of an aging brain.)

 

I also would strengthen the rules of sports to eliminate these head injuries without taking away from the sport itself. We have loved our sports for decades without relying on violence to be entertained. If officials enforced rules prohibiting purposeful hits intended to hurt the opponent, this violence would abate. First time, out of the game; second; out for the year; third time—the player is finished and so is the coach!! We are not (at least not yet) the Romans in the Coliseum!!

 

As an aside to this blog, I have to mention what was discussed on a Dr. Oz show just the other day. He told his audience that they did not need any more Vitamin C than what they could get through a multi-vitamin and their “normal diet.” I am so disappointed by his saying this. It shows a basic misunderstanding of the existing and recent research on vitamins. The definitive text on the need for nutrients was done by Roger Williams, PhD. In the particular discussion on Vitamin C, Dr. Williams noted that to achieve “cell saturation” (or a healthy level of the vitamin) in his test subjects, the amount of the vitamin supplied varied between 250mg and 10,000mg. That’s an enormous disparity!!! And please remember that the amount of the RDA by the government is 60mg!!! This is so inadequate as to be laughable. I recommend at least 1,000mg of supplemental Vitamin C and more if there are any health problems at all. Dr. Oz, I disagree with you entirely!

 

Give us a call–we need to talk!

 

Dr. Baldwin works with people by utilizing the modern technique known as “telemedicine,” and he would love to help you. You do not have to come to Delaware! I also can help you as a “Medical Advocate.” What this means is that, if you have questions about health matters, including the interpretation of laboratory testing, you can contact me and we will discuss what your test results mean and help you get good answers to your questions. It seems that today everyone, including doctors, is in a rush and you end up getting the short end of the stick. We can help with that problem. Just give us a call at 410-326-6690.

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Malabsorption Syndrome

In our last discussion we looked at why someone who is not feeling well and yet is eating a “healthy diet,” and taking supplements might still be deficient in nutrients due to the lack of quality of those supplements. This time, let’s take a look at what is becoming an epidemic in humans: Malabsorption Syndrome.

 

There are several reasons for the occurrence of Malabsorption Syndrome:

The most common is when the gut is damaged as in leaky gut syndrome, subclinical celiac disease, food allergies, and other issues which affect the integrity of the gut lining. If the gut is damaged, the nutrients we take in whether in the form of food or supplements cannot be absorbed properly and the person becomes undernourished. If advanced enough, proteins, vitamins and minerals from the diet and from supplements can actually enter the bloodstream through this damaged area of the gut and cause an inflammatory response throughout the body because they should be absorbed through the digestive system and therefore the body sees them as foreign to itself.

 

Subclinical celiac disease damages the gut lining because gluten and gliadin react with the gut lining when grains are eaten. Modern day grains for the most part bear no relationship to those eaten by our ancestors. While not frank celiac disease, this is called gluten intolerance, and is a real and epidemic problem. A gluten-free diet for 30 days is an excellent way to allow the gut to begin to heal.

 

Toxicity damages the gut lining, the gall bladder and the liver. (Toxicity damages all body cells, but we are just talking about Malabsorption Syndrome in this blog.) Again, foods and supplements are not broken down in an effective way, and the person becomes undernourished and does not function well in any capacity. A professionally guided detoxification is the only way to correct a toxic state.

 

Poor gut bacteria due to inadequate diet, poor supplementation, and antibiotic use is another way that Malabsorption Syndrome occurs. If you have followed my Newsletters and Blogs throughout the years, you know that I believe the most important supplement we can take is a high quality probiotic. This will strengthen your body, including the immune system, 75-80% of which comes from the healthy bacteria in the gut.

 

But there’s a lot more to a healthy gut than just probiotics. We follow a program called “The Four R’s of Gut Repair.” This involves Removing both foods that may damage the patient’s gut and infectious “bugs.” Reinoculating with healthy probiotics is step two. Then we Replace missing digestive enzymes and acids. Repairing the gut lining is step four. The process may take many months or just a few weeks depending on the individual patient’s needs.

 

The last step to getting all the body’s nutritional needs fulfilled is to follow what is prescribed by the treating doctor or nutritionist. This goes without saying, and does not demand any further explanation!

 

Give us a call–we need to talk!

 

Please pass this blog along to your friends, family, and co-workers. We work with people by utilizing the modern technique known as “telemedicine,” and we would love to help you. You do not have to come to Delaware! We also can help you as a “Medical Advocate.” What this means is that, if you have questions about health matters, including the interpretation of laboratory testing, you can contact us and we will discuss what your test results mean and help you get good answers to your questions. It seems that today everyone, including doctors, is in a rush and you end up getting the short end of the stick. We can help with that problem. Just give us a call at 410-326-6690. Also, check out our Web Site at http://www.wholebodyhealth.us for more info.

Qulaity of Supplements

I was talking to a long-time patient recently and she told me an interesting story. It seems that she was feeling really good, and then she started to go downhill. She was feeling a lack of energy, lack of motivation, and coming down with infections that she hadn’t had before. After talking to her I decided that the best way to proceed was to go through an up-to-date workup and re-evaluation. She agreed, and I sent her the documents necessary to update her condition so that we could update her nutritional needs. (This can all be done by phone.)

 

When someone has been taking nutritional supplements and finds over time that they are going downhill, or at least not doing as well as they were in the past, it is usually due to one of three things:

1. They are not taking high quality supplements.

2. They are not absorbing the vitamins, electrolytes, and minerals that their body requires to function optimally.

3. They are not following what we asked them to do based on our workup or they are not eating a healthy diet.

 

Let’s take these in order.

 

When I looked at this patient’s “Systems Survey” when she had returned it to me, I realized that she was taking several supplements which she had not obtained from me. I asked her on the phone consult why she was taking these, and I also asked where she had purchased them. She told me that she had heard about the “extra” supplements from various sources: television, magazines, friends, workmates, and even the health food store. None of these sources had tested her nor did they know anything at all about her health status and needs. She also had stopped taking certain supplements that I had originally recommended after evaluating her needs scientifically.

 

Our office distributes professional quality medical foods and dietary supplements. The products we carry are scientifically formulated to support specific aspects of health and we understand the health of our patients to whom the products are recommended. Online and store-front retailers are not authorized to sell most of the products we offer. Many of these products are relabeled, counterfeited, or damaged. Many on-line products are sold by “bait and switch” tactics where you think you are getting the original products, but the retailer does not have them and will substitute an inferior brand while telling the purchaser that it is “just as good.”

 

Several things can be learned from this exchange:

1. We stand behind the quality and purity of every product we sell. Our Mission is to help you achieve Optimal Health, and you can trust what you purchase from us.

2. We strive to make high quality affordable. We do not charge “suggested retail price,” but instead we discount the products for our patients.

3. We do not sell supplements to people we do not know. We believe in the phrase “Test–don’t guess.” If it has been a while since we have worked up a health profile for you, give us a call and we will do a new work-up at a reasonable price and restart your engine!

 

Don’t play around with your health, and don’t try to cut corners for a few pennies.

More on absorption, and particularly “Malabsorption Syndrome” next time.

 

Give us a call–we need to talk!

 

Please pass this blog along to your friends, family, and co-workers. We work with people by utilizing the modern technique known as “telemedicine,” and we would love to help you. You do not have to come to Delaware! We also can help you as a “Medical Advocate.” What this means is that, if you have questions about health matters, including the interpretation of laboratory testing, you can contact us and we will discuss what your test results mean and help you get good answers to your questions. It seems that today everyone, including doctors, is in a rush and you end up getting the short end of the stick. We can help with that problem. Just give us a call at 410-326-6690. Also, check out our Web Site at http://www.wholebodyhealth.us for more info.

Your Desired Eulogy

We were driving in the car on Easter Sunday, and we heard talk show host Tom Rose reading from a speech given by David Brooks of the New York Times. This speech shook me to my very core! It has a great deal to do with one of the Four Pillars of Optimal Health, Lifestyle Changes. Although it will lead to a very unusual blog post, I need to share this speech with you, and then I am going to give you a “homework” assignment. Here it is:

 

“I’ve been thinking about the difference between the resume virtues and the eulogy virtues. The resume virtues are the ones you put on your resume, which are the skills you bring to the marketplace. The eulogy virtues are the ones that get mentioned in the eulogy, which are deeper: who are you, in your depth, what is the nature of your relationships, are you bold, loving, dependable, consistent? And most of us, including me, would say that the eulogy virtues are the more important of the virtues. But, at least in my case, are they the ones that I think about the most? And the answer is no.

 

“So I’ve been thinking about that problem, and a thinker who has helped me think about it is a guy named Joseph Soloveitchik, who was a rabbi who wrote a book called “The Lonely Man of Faith” in 1965. Soloveitchik said that there are two sides of our natures, which he called Adam I and Adam II. Adam I is the worldly, ambitious, external side of our nature. He wants to build and create (create companies, create innovations). Adam II is the humble side of our nature. Adam II wants not only to do good but to be good, to live in a way internally that honors God, creation and our possibilities. Adam I wants to conquer the world. Adam II wants to hear a calling and obey (that calling). Adam I asks how things work. Adam II asks why we’re here. Adam I’s motto is “success.” Adam II’s motto is “love, redemption, and return.”

 

“And Soloveitchik argues that these two sides of our nature are at war with each other. We live in perpetual self-confrontation between the external success and the internal value. And the tricky thing, I’d say, about these two sides of our nature is they work by different logics. The external logic is an economic logic: input leads to output, risk leads to reward. The internal side of our nature is a moral logic and often an inverse logic. You have to give to receive. You have to surrender to something outside yourself to gain strength within yourself. You have to conquer the desire to get what you want. In order to fulfill yourself, you have to forget yourself. In order to find yourself, you have to lose yourself.

 

“We happen to live in a society that favors Adam I, and often neglects Adam II. And the problem is, that turns you into a shrewd animal who treats life as a game, and you become a cold, calculating creature who slips into a sort of mediocrity where you realize there’s difference between your desired self and your actual self. You’re not earning the sort of eulogy your want and that you hope someone will give for you. Your don’t have the depth of conviction. You don’t have an emotional sonorousness. You don’t have commitment to tasks that would take more than a lifetime to commit.

 

“I was reminded of a common response through history of how you build a solid Adam II, how you build depth of character. Through history, people have gone back into their own pasts, sometimes to a precious time in their life, to their childhood, and often, the mind gravitates in the past to a moment of shame, some sin committed, some act of selfishness, and act of omission, of shallowness, the sin of anger, the sin of self-pity, trying to be a people pleaser, a lack of courage. Adam I is built by building on your strengths. Adam II is built by fighting your weaknesses. You go into yourself, you find the sin which you’ve committed over and again through your life, your signature sin out of which the others emerge, and you fight that sin and your wrestle with that sin, and out of that wrestling, that suffering, then a depth of character is constructed. And we’re often not taught to recognize the sin in ourselves, in that we’re not taught in this culture how to wrestle with it, how to confront it, and how to combat it. We live in a culture with an Adam I mentality where we’re inarticulate about Adam II.

 

“Finally, Reinhold Niebuhr summed up the confrontation, the fully lived Adam I and Adam II life, this way: ” Nothing that is worth doing can be achieved in our lifetime; therefore, we must be saved by Hope. Nothing which is true or beautiful or good makes complete sense in any immediate context of history; therefore, we must be saved by Faith. Nothing we do, however virtuous, can be accomplished alone; therefore, we must be saved by love. No virtuous act is quite as virtuous from the standpoint of our friend or foe as from our own standpoint. Therefore, we must be saved by that final form of love, which is forgiveness.”

 

What a beautiful speech! Now for the “homework” assignment. As part of the improvement in your Lifestyle Changes I’m asking you to take some quiet time and sit down and write what you would like to have said at your own funeral as a eulogy. Read it over and make any changes you think you would like. Then put it away. In two weeks or so, pull it back out and read it again—make changes that you like. Then—live your life like this!!! Earn that eulogy! I believe this will bolster you Four Pillars of Optimal Health in ways you cannot imagine until you do it.

 

Give us a call–we need to talk!

 

“I really don’t like looking back and saying I regret decisions I made in the past, because they were the right decisions for me with the knowledge I had at the time, but I would love for someone to build me a time machine so that I can go back and say “no” to having chemotherapy and surgery….I have absolutely no doubt that healing would occur much easier and faster if I wasn’t dealing with the collateral damage caused by those harsh conventional treatments.”

          Jessica Ainscough at http://www.thewellnesswarrior.com/au describing                        how she healed from cancer.

 

Please pass this blog along to your friends, family, and co-workers. We work with people by utilizing the modern technique known as “telemedicine,” and we would love to help you. You do not have to come to Delaware! We also can help you as a “Medical Advocate.” What this means is that, if you have questions about health matters, including the interpretation of laboratory testing, you can contact us and we will discuss what your test results mean and help you get good answers to your questions. It seems that today everyone, including doctors, is in a rush and you end up getting the short end of the stick. We can help with that problem. Just give us a call at 410-326-6690. Also, check out our Web Site at http://www.wholebodyhealth.us for more info.

Everybody is toxic!!

This is a topic that is very close to my heart, and about which I know a great deal through personal experience! Environmental toxins—such as heavy metals (for instance, “silver” dental fillings, drinks in aluminum cans, leaded paint, cigarette smoke, gasoline fumes), industrial compounds, pesticides in and on food, abnormal estrogens from  plastics and Styrofoam heated in microwaves, solvents used in the home environment, diet sodas,  artificial sweeteners, and countless other toxins—find their way into our bodies every day. We are literally swimming in a sea of toxins in the water we drink, the air we breathe, and the food we eat. These toxins have names like phthalates (from plastics), styrene (from Styrofoam), parabens, and dioxins (from pesticides, plastics, and other chemicals). And this is far from being totally inclusive! Research has shown that these chemicals cause over 85% of the diseases afflicting mankind today—especially cancer, heart disease, and endocrine diseases.

Over time, an accumulation of these toxins can reduce energy levels and accelerate aging, as well as negatively impact immune, neurological, and overall health. Skillful physicians in all cultures have relied on purification strategies to harmonize and balance body biochemistry to induce the body into a pattern of self healing. Specialized nutritional support to enhance detoxification capacity can help you stay healthy.

A poorly planned program can drain your energy and redistribute toxins (such as heavy metals and pesticides) to vital organs. The goal must be to incorporate a cleansing diet, targeted natural supplements, exercise, and lifestyle changes to help gently remove toxins over time while promoting overall wellness.

To do a detoxification or even cleansing properly you must have professional help from a qualified health-care professional. It scares the heck out of me to see signs outside of health food stores and supplement shops which advertise their “Spring detox and cleanse” programs. It’s sad to say, but they just do not have the proper personnel to help you with this medical process.

Detoxification is a two-step process: the organs of detoxification and the whole body are prepared to have the ability to get rid of toxins (if they were already strong enough, you wouldn’t be toxic) and only then the toxins are pulled from the tissues for elimination. We can help you with this process.

Give us a call–we need to talk!

 

“I really don’t like looking back and saying I regret decisions I made in the past, because they were the right decisions for me with the knowledge I had at the time, but I would love for someone to build me a time machine so that I can go back and say “no” to having chemotherapy and surgery….I have absolutely no doubt that healing would occur much easier and faster if I wasn’t dealing with the collateral damage caused by those harsh conventional treatments.”

          Jessica Ainscough at http://www.thewellnesswarrior.com/au describing                        how she healed from cancer.

 

Please pass this blog along to your friends, family, and co-workers. We work with people by utilizing the modern technique known as “telemedicine,” and we would love to help you. You do not have to come to Delaware! We also can help you as a “Medical Advocate.” What this means is that, if you have questions about health matters, including the interpretation of laboratory testing, you can contact us and we will discuss what your test results mean and help you get good answers to your questions. It seems that today everyone, including doctors, is in a rush and you end up getting the short end of the stick. We can help with that problem. Just give us a call at 410-326-6690. Also, check out our Web Site at http://www.wholebodyhealth.us for more info.

Treating Depression

As we discussed last time, depression is caused by a biochemical imbalance. This is no longer debatable, and the answer to treating depression is to correct the causes of this imbalance. The lack of vitamins, minerals, and other natural substances normally found in the body is what causes a chemical imbalance, and this is what must be addressed when treating a disease state. The chemical imbalance is caused by either a lack of intake of proper fuel (nutrition), blockage against the use of this fuel (poor digestion), or an inability to get rid of toxins that build up naturally through metabolic processes, or through the food, air, and water that permeate our lives. I can tell you that depression is not of a lack of a pharmaceutical drug. And while I support “talk therapy,” all the talking in the world will not correct a chemical problem. Furthermore, depression does more than cause pain to the person afflicted. It hurts everyone with whom they come in contact.

One thing that leads to depression is what is referred to as “Seasonal Affective Disorder (SAD). (This acronym SAD is also used to describe the “Standard American Diet.” Hmmmm–might just be some relationship there!) We now know that SAD can be caused by a lack of Vitamin D3. Especially in the winter, there is not enough intensity to sunlight to allow the body to make vitamin D3 (the only kind the body makes or utilizes). So, we supplement this lack of D3 through diet and dietary supplementation with D3. (Dietary sources of Vitamin D3 are wild salmon, sardines, tuna in oil (beware of mercury), and free-range eggs.)

We know that depression can be caused by heavy metal toxicity. This is a major cause and most professionals do not know how to properly test for it let alone treat it.

Excessive insulin and leptin resistance (due to too much sugar and grains in our diets), deficiency of omega 3 fatty acids in our diets, lack of the B vitamins (especially B12), sodium deficiency, poor intestinal probiotic levels, the use of statin drugs to “lower cholesterol” are all contributing causes to depression.

The way to approach the treatment of depression is to strengthen the Four Pillars of Optimal Health and then to correct any remaining chemical imbalance. You should not attempt to do this without experienced and competent professional guidance.

(Of the Four Pillars of Optimal Health, only the Lifestyle changes should be done by yourself without professional help. Dietary decisions, exercise, and supplementation all require some guidance.)

Give us a call–we need to talk!

“I really don’t like looking back and saying I regret decisions I made in the past, because they were the right decisions for me with the knowledge I had at the time, but I would love for someone to build me a time machine so that I can go back and say “no” to having chemotherapy and surgery….I have absolutely no doubt that healing would occur much easier and faster if I wasn’t dealing with the collateral damage caused by those harsh conventional treatments.”
Jessica Ainscough at http://www.thewellnesswarrior.com/au describing how she healed from cancer.

Please pass this blog along to your friends, family, and co-workers. We work with people by utilizing the modern technique known as “telemedicine,” and we would love to help you. You do not have to come to Delaware! We also can help you as a “Medical Advocate.” What this means is that, if you have questions about health matters, including the interpretation of laboratory testing, you can contact us and we will discuss what your test results mean and help you get good answers to your questions. It seems that today everyone, including doctors, is in a rush and you end up getting the short end of the stick. We can help with that problem. Just give us a call at 410-326-6690. Also, check out our Web Site at http://www.wholebodyhealth.us for more info.

The Nightmare of Depression

Spring must be getting close, because baseball Spring Training has started!! I’ve always thought that the main reason for baseball’s popularity is that when baseball begins, it signals the end of Winter. When the “Boys of Summer” begin to play, it makes a lot of people happy!

This reminds me that happiness is an emotion that is associated with enhanced physical health and a feeling of well-being. While “happiness” is rather subjective, it is also to a large extent an emotion that is almost totally under our control. We can, for the most part, determine what emotions affect us on a day-to-day basis. So why are there so many prescriptions written for drugs to deal with depression? Why is depression the number one “disease” afflicting our populace?

The answer to these questions is really easy: it is because of a biochemical imbalance. (Please refer back to our blog on Biochemical Imbalance.) Depression is caused by Biochemical Imbalance. Since this statement is backed by volumes of scientific evidence, and is accepted by virtually all mental health professionals, what good are prescription drugs except to “treat” depression and all other emotional “diseases” symptomatically? The drugs have nothing to do with the causes of emotional “diseases,” they only treat the symptoms, but with massive side effects, some of which can kill!

Happy people tend to live longer. Happiness protects your body from stressors that can lead to coronary heart disease. It boosts your immune system’s ability to fight off the common cold and other diseases. We all want to be happy! So again, why is there so much depression in a society that has so much. Do we not know how blessed people in this country are? Yes, we do know, but we are unbalanced chemically, and we cannot make the connection.

One thing that leads to depression is what is referred to as “Seasonal Affective Disorder (SAD). (This acronym SAD is also used to describe the “Standard American Diet.” Hmmmm–might just be some relationship there!) We now know that SAD can be caused by a lack of Vitamin D.

We know that depression can be caused by heavy metal toxicity. This is a major cause and most professionals do not know how to properly test for it. My Goodness, the American Dental Association still thinks that mercury does not contribute to neurological and mental diseases!

Other causes of depression, teen psychological disorders, autism, ADD, ADHD, OCD and other mental diseases can be excessive insulin and leptin resistance (due to too much sugar and grains in our diets), deficiency of omega 3 fatty acids in our diets, lack of the B vitamins (especially B12), sodium deficiency, poor intestinal probiotic levels, the use of statin drugs to “lower cholesterol,” and others.

Subclinical symptoms of depression are also very real. This “almost depressed” category can lead to lower job satisfaction, lower satisfaction with one’s mate and family, lower personal relationships, more anxiety issues, less control over one’s life, and lower overall well-being. Seventy-five percent of those with subclinical depression will devolve into full-blown major depression if they are not recognized and the problem treated by balancing the person chemically.

In the next blog we will go into diagnosis and treatment of depression using natural means. You can help yourself and those you love if you just take charge, contact us, and follow up for your own good!

Give us a call–we need to talk!

“I really don’t like looking back and saying I regret decisions I made in the past, because they were the right decisions for me with the knowledge I had at the time, but I would love for someone to build me a time machine so that I can go back and say “no” to having chemotherapy and surgery….I have absolutely no doubt that healing would occur much easier and faster if I wasn’t dealing with the collateral damage caused by those harsh conventional treatments.”
Jessica Ainscough at http://www.thewellnesswarrior.com/au describing how she healed from cancer.

Please pass this blog along to your friends, family, and co-workers. We work with people by utilizing the modern technique known as “telemedicine,” and we would love to help you. You do not have to come to Delaware! We also can help you as a “Medical Advocate.” What this means is that, if you have questions about health matters, including the interpretation of laboratory testing, you can contact us and we will discuss what your test results mean and help you get good answers to your questions. It seems that today everyone, including doctors, is in a rush and you end up getting the short end of the stick. We can help with that problem. Just give us a call at 410-326-6690. Also, check out our Web Site at http://www.wholebodyhealth.us for more info.