By Dr. Dhai Barr

Being happy is good for you. 
For years researchers, psychologists, and doctors have told us of the connection between happiness and health.  There is compelling research that looks at the negative health effects caused by stress and anger.  Many studies show that various states of happiness can lower the stress related hormones.  Study after study agrees that happier people live longer.  This is true in both individuals as well as in communities.

How Does Happiness Affect Our Health? 
Many key studies look at associations between health and happiness. These studies focus on correlations that are not necessarily caused by one another, but that positive mood, optimism and humor are linked to better health and well-being.  Cardiovascular function such as decreasing high blood pressure and improving heart rate with happiness and positive well being.  Immune function and the inflammatory process are affected by our happiness.  Cortisol levels fall when we are happy, due to the direct correlation on stress, or in this case, lack of stress.  Cortisol, when released in high amounts for a prolonged period of time, can contribute to insomnia, increased abdominal fat, lowered immunity, high blood pressure, and a plethora of other symptoms.  Being happy will lower these unwanted effects.  

How do we evaluate happiness?
Happiness is subjective, so how do the professionals actually measure it?  There are many ways to evaluate happiness.  Researchers, doctors and investigators use surveys and questionnaires to place a measurable value on happiness.  These include the Oxford Happiness Inventory (Argyle and Hills), Subjective Happiness Scale (Lyubomirsky and Lepper), Satisfaction with Life Scale (Diener, Emmons, Larsen and Griffin), and Panas Scale (Watson, Clark and Tellegen).  These scales basically measure a person’s sense of well-being.  

How do we cultivate happiness?
What are the secrets to happiness?  How does one become more satisfied with life?  When you ask those that score the highest on the evaluations you will find common threads in the lives of the “happiest” people:  

• Having strong social networks that includes family and friends, and spiritual connections
• Engaging in activities that support strengths, values and lifestyle
• Practicing gratitude daily
• Having a positive thinking style
• Showing random acts of kindness
• Recognizing material wealth is only a small portion of the abundance 
• Developing healthy coping strategies to deal with stress
• Focusing on a healthy mind and body
• Cultivating spiritual emotions
• Having direction and meaning in your lives

We can increase our levels of happiness!  Many of the traits and habits listed above are attainable with intent and motivation.  Some easy places to start are to practice mindfulness or meditation.  There are many mind and body techniques that can release tension and improve a sense of calm and wellness.  Take up yoga.  Pay it forward, or begin the chain, with random acts of kindness.

What are the Secrets of Happiness?
Gratitude!  Researchers have found that people who keep a gratitude journal on a regular basis have an increased satisfaction in life, higher energy levels and have improved health.  Expressing gratitude is a demonstrated way of fostering happiness. 
Connections!  Spend more time connecting with friends and family.  Take time for meaningful conversations.  Close social support is critical for happiness. Those in loving relationships are the most satisfied.  Get out and meet new people, join a club or meet-up, go to church or spiritual gatherings or other interesting groups.
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Healthy Habits! People who exercise and get enough rest are happier.  Practice good sleep hygiene, keeping regular hours.  Get out often to exercise, explore nature.  
Don’t forget happiness is contagious!  Get out there and share.  Smile at others with an open heart.  Answer the phone with a smile on your face; it comes right through the phone.  The more you begin implementing these habits in your daily life, the easier it will be to achieve a sense of well-being and contentment.  You have nothing (but resentment and poor health) to lose.  Try it out – your body will thank you.

“As we age we sink, we sag, and we wrinkle” 
 
The key to facial rejuvenation is to restore the original shape of your face, and to encourage new collagen growth.  Dr. Barr has several treatments that do just that.  Each of her treatments are safe and simple and can be done alone or in combination with other treatments, to achieve your desired skin appearance.
 
We all know that age-related skin changes are due to multiple factors, including how much sun exposure you’ve had over your lifetime, your nutritional habits, the environment in which you live, and genetics. What few of us realize are that all of these causes of aging can be treated with natural methods and, to some degree, reversed.
 
The first signs of aging skin are usually visible in the fine lines of crow’s feet, and also in the deepening of the nasal labial folds around the nose and mouth.  Neuromodulators (Botox and Dysport) work to reduce lines and wrinkles by turning off the ability for the nerve and muscle to communicate. This reduces the muscle’s ability to contract.  When it cannot contract it cannot form the line in your skin that we call a wrinkle.  With repeated neuromodulator use your collagen will naturally regrow fibers and erase lines.  Neuromodulators are safe and affordable.  The body will notice that this nerve has been turned off and over time repairs it. This is why neuromodulators need to be repeated every 3-6 months (depending on your body and its reaction to the medicine).  This treatment takes about 15 minutes.
 
The natural “chemical” peels that she uses are much like having a facial done with longer lasting results.  Peels are designed to dissolve the glue that holds the top layer of skins cells together.  This speeds up the exfoliation process of the natural skin cell cycle, causing the body to increase the speed of new cell development.  New cellular growth evens out skin tone and texture, tightens pores, reduces fine lines, improves superficial blood vessels and produces an overall glow. Peels help a variety of conditions besides aging skin and can be used to treat rosacea, acne, and hyperpigmentation.  They’re done in less than an hour and there is virtually no down time.  You may have some minor flaking for 3-5 days after the peel.
 
Dermal Fillers are used to fill up both deep and superfine wrinkles as well as to augment volume loss. Depending on what we are treating, Dr. Barr will recommend the best fillers for the job.  The hyaluronic acid family of fillers (Lyft, Juvederm, Silk, Kysse, Voluma and Restylane) are good for nasal labial folds, marionette lines, the lines around your mouth, your lips, under your eyes and for cheek enhancement.  Refyne and Defyne (also in the Restylane family) are used similarly but in areas with more movement as they flex with your facial expressions.  Sculptra is used primarily to build volume over a period of 6-8 months.  It is ideal for mid-face volume, fat loss in the temples, nasolabial folds and cheeks.
 
Microneedling is a very effective anti-aging treatment.  Also known as collagen induction therapy, CIT, microneedling uses a device to deliver rapid needle piercing all over the face after it has been numbed.  These little punctures stimulate the skin to produce collagen and release tissue growth factors.  We then can paint on your own Platelet Rich Plasma, driving it into the skin.  Adding PRP is like adding superman juice to the healing cascade.  This treatment is almost painless because of the topical anesthetic applied.  You may have a day of two of mild redness.  Some people may have a small amount of skin flaking for about a week after treatment.
 
With all of these options available, you can restore and rejuvenate your face. Dr. Dhai Barr will help you choose the best treatment for your unique needs. From neuromodulators to lasers, there’s a therapy for everyone. 

Everybody wants to turn back the hands of time when it comes to the aging face.  Collagen induction therapy using a microneedling device along with Platelet Rich Plasma (PRP) is a natural, safe and cost effective technique to help in rejuvenating the skin and reversing the aging process.  
 
This treatment is aimed at treating fine lines and wrinkles as well as volumizing deeper wrinkles.  It is an excellent choice for under eye tear troughs, nasal labial folds, marionette lines, peri-oral lip lines as well as a lip filler.  It improves the texture of the area treated, lifts acne scars and fills in cheeks and chins as well as tightens pores.
 
This dermal stamping with the multiple microneedle pen or by injection technique using platelet rich plasma (PRP) that is utilized as an autologous (from your body) alternative for dermal volumetric regeneration and rejuvenation versus synthetic dermal or hypodermal augmentation products.

The PRP acts as a biologic scaffold that comprises a “structure and signals” process that includes the 5 major steps of physiological wound healing:

• Formation of a tri-dimensional fibrin strand, including platelets and white blood cells that functions as a bio-active ‘scaffold’
• Platelet mediated release of growth factors in their biologically determined ratios 
• Chemo-attraction of macrophages and stem cells to the site of bio-active ‘scaffold’
• Stem cell proliferation 
• Stem cell differentiation in the vicinity of the bio-active ‘scaffold’

 
 
The Benefits of PRP 

• Tissue regeneration and rejuvenation: neo-collagenesis, neo-vascularisation, & extracellular matrix formation
• Non-allergenic because it is a ‘body own’ physiological product vs. animal-derived 
• Elimination of donor transmissible infections
• Increase in the rate of the healing process 
• Physiological ‘antibiotic’ as a result of anti-bodies and white blood cells present in plasma
• Cellular expansion of several cell types (e.g. fibroblasts, collagen, elastin, keratinocytes and white blood cells, etc.)

 
 
The Benefits of Collagen Induction Therapy

• Leaves the epidermis intact and does not damage the skin
• Stimulates collagen production in the dermis
• Skin becomes thicker as collagen and elastin are increased 
• Is as effective as lasers 
• Safe for darker skin patients with no fear of hyperpigmentation
• Short healing period
• Can treat anywhere on the body
• Results are natural and long lasting
• Lower risks and side effect compared to more aggressive procedures

 
 
 
What to expect at Your Treatment 
Topical anesthetic cream is applied 20-30 minutes prior to treatment.  A small amount of blood will be drawn from your arm to be spun down to collect the platelets.  The type of treatment you are having done will determine injection technique.  Linear threading, micro needling, fanning, cross-hatching and mesotherapy are common methods used.  
 
Depending on the technique used you may experience some bruising and swelling, this is usually minor and resolves quickly.  With the microneedle treatment you will only experience a slight redness similar to a sunburn that resolves within the day.  It is advised to forego any icing, anti inflammatory drugs such as aspirin or ibuprofen as this impairs platelet activation.  Pain is minimal to non existent.  With the PRP injections there is typically increased risk of bruising and swelling.
 
 
Treatment schedule/Patient selection 
At the age of 27 years our bodies produce less collagen and elastin, thus the aging process begins.  This aging process is complicated by environmental factors such as pollution and UV damage, one’s lifestyle such as alcohol, exercise, smoking or poor diet choices, and disease.
 
Between the ages of 30-39 years ones main goal is rejuvenation and prevention.  To slow down the aging process one treatment every 1-2 years is sufficient. 
 
From 40-49 ones aim is not only rejuvenation but reversing the aging process.  More stimulation of the collagen and elastin is necessary.  Best results are seen with 2-3 treatments over a 3-4 month period.  
 
50 years and older need a more intense reversal of the aging process.  The initial treatment should be followed up by a second treatment at 1 month and a third at 3-4 months.  Maintenance treatments should be scheduled every 12 months.
 
 
What to Expect after treatment
The results of collagen induction therapy are subtle and gradual improvement occurs over time.  Viable signs are seen as early as 3-5 weeks.  Collagen production peaks around 12 weeks and as it grows full results can be appreciated around 5-6 months post treatment.
 
 
Is Collagen Induction Therapy right for you?

• If you want to improve the look of your skin’s tone and texture
• If you want to smooth out fine lines and wrinkles
• If you are interested in growing and stimulating your own collagen and elastin
• If you want to regain smooth more youthful skin

 

Pretreatment preparation 
Patients are advised to start taking products that stimulate fibroblasts to produce more collagen such as Vitamin C (1000-2000mg daily), and Vitamin D (1000-2000iu daily).  Topical skin serums such as retinols and Vitamin C are recommended prior and post treatment to activate the fibroblasts.
 
Avoid anti-inflammatory agents such as aspirin, ibuprofen or fish oil for 7-14 days prior to treatment and again 7-14 days post treatment.
 
 
 
 
 
 
 

If you want to get fit and lose weight, you should exercise as hard as you can, for as long as you can, every day, right? Wrong! Researchshows extreme exercise can cause chronic health problems and make you feel worse. (What constitutes over exercise depends on the individual and their fitness level.) Recovery time is as important as the exercise itself.


Over exercising can cause the following health issues:

• Increased inflammation
• Fatigued adrenals, the stress-handling glands
• More bad gut bacteria 
• Leaky gut
• Depleted hormones
• Depressed immunity
• Increased risk of injury
• Bone loss

Too much exercise raises inflammation
Many of the issues caused by over exercising stem from inflammation. Although appropriate exercise can be anti-inflammatory and very good for the brain, too much has the opposite effect. 
The cellular damage from over exercising triggers a systemic inflammatory response that sets the stage for a host of other health problems.

Too much exercise stresses out your body
The damage and inflammation from over exercising is very stressful to the body. Excess stress underlies the burnout, depletion, and increasing weakness often seen with over exercising. Results can be fatigue, poor thyroid function, depressed immunity, and more.

Over exercising damages gut health
The gut and the bacteria it houses are increasingly being recognized as the seat of the immune system and foundational to our health. 
Overdoing exercise has been found to damage the gut wall, causing “leaky gut.” This allows undigested foods, bacteria, yeast, and other pathogens into the bloodstream, where they then trigger inflammation throughout the body.

Overtraining also changes the composition of gut bacteria so there is too much bad bacteria. 

How to know if you’re over training
How do you know if your exercise routine is making you unhealthy?

One of the most common symptoms is constant fatigue. Your workout routine should give you more energy, not less. Appropriate exercise boosts chemicals in the body that improve brain function, increase well being, and raise energy. If the opposite is happening to you, you’re overdoing it.

Other symptoms of over exercising include getting sick frequently, loss of muscle mass, gaining body fat, and difficulty recovering from injuries. 

What to do if you’re over exercising
If you’re making yourself sick with exercise, the answer isn’t to stop exercising, but to go about your workouts differently. First of all, give yourself time to recover. This typically means exercising less frequently. 
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Also, it’s very important to get enough sleep. This is a critical time when your muscles repair and your metabolic system and brain recharge. Sufficient sleep is crucial if you want to stay active and healthy for the long haul. 
 
 

A recent study confirmed what functional medicine has long since known — the autoimmune paleo (AIP) diet is highly successful for managing chronic health disorders. The first-of-its-kind study showed the majority of participants quickly achieved and maintained remission of Crohn’s disease and ulcerative colitis on the AIP diet. A number of participants were even able to discontinue drug therapies.
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Many people follow the AIP diet to manage not just Crohn’s but also chronic pain, Hashimoto’s hypothyroidism, irritable bowel syndrome, skin rashes such as eczema or psoriasis, high blood pressure, depression, anxiety, brain-based disorders, diabetes, autoimmune disease in general, and other chronic health problems.

People are surprised to find that not only do their symptoms fade but also they enjoy more energy, better sleep, weight loss, increased libido, less stress, and a general overall improvement of their well being.

A primary reason the diet is so effective is because it helps repair leaky gut, a condition in which the lining of the gut becomes inflamed and porous, allowing inflammatory compounds into the bloodstream. This creates inflammation throughout the body and brain and leads to a wide array of chronic gut, metabolic, and autoimmune disorders.

Anti-inflammatory is the key to the AIP dietAn anti-inflammatory diet focuses on whole foods and is free of inflammatory foods, additives, fillers, and artificial colors. It includes an accompanying protocol of appropriate sleep, physical activity, rest, and positive socialization and self-treatment. Certain nutritional compounds that gently cleanse and detoxify the body may boost the success of the diet.
AIP diet sites and articles abound, but here are basics:

• Eliminate all processed foods, fast foods, desserts, coffee drinks, sodas, etc. Your anti-inflammatory diet should consist of whole foods found in the produce and meat sections of the grocery store, with an emphasis on plenty of vegetables. Also eliminate processed vegetable oils and hydrogenated oils and stick with natural oils.
• Eliminate common inflammatory foods, the most common culprit being gluten. Many people’s symptoms resolve simply on a gluten-free diet. However, dairy, eggs, soy, nuts, grain, and nightshades are commonly immune reactive as well. Eliminate these foods for about six weeks to see whether you react upon reintroducing them one at a time.
• Eliminate sweets. On the anti-inflammatory diet you will avoid all sweeteners. This helps curb cravings, stabilize blood sugar, lower inflammation, and lose excess fat. Enjoy low-sugar fruits instead, such as berries.
• Eat lots of vegetables. Not only do plenty of veggies load you up with vital nutrients and fiber, new research shows they create a healthy gut microbiome – the bacteria in your gut that profoundly influence your immune and brain health. A diet based around veggies creates an abundant and diverse gut microbiome and thus better health.
• Get enough sleep and exercise. Sufficient sleep is a major inflammation-buster, as is regular physical activity. Overtraining, however, can cause inflammation so watch out for that.

Boost success with gut repair and detoxification. Adding in specific nutritional compounds can help repair a damaged gut, lower inflammation, support the liver, and detoxify the system. Ask my office for more information about a detoxification and gut-repair program using the AIP diet.

​A recent study found regular use of proton pump inhibitors (PPIs) for acid reflux raises the risk of stomach cancer. PPI users (Prilosec, Prevacid) in the study had twice the risk for stomach cancer compared to those who used H2-receptor acid reducing drugs (Tagamet, Pepcid). 

About 20 percent of Americans suffer with acid reflux and heartburn. Most people attribute acid reflux to excess stomach acid. However, the problem is too littlestomach acid. How does low stomach acid cause acid reflux?

The stomach is highly acidic by design so that it can quickly break down foods and kill bacteria, fungi, and other pathogens. Good stomach acidity also helps absorb minerals and signal the rest of the digestive tract to release the right hormones, enzymes, and emulsifiers. Sufficient stomach acid is an important first step in ensuring overall digestion runs smoothly and that you are less susceptible to heartburn, indigestion, belching, gas, food allergies, bacterial infection, and abdominal pain.

What causes low stomach acid?
Common factors that cause low stomach acid include stress, bacterial infection, poor diet, and nutritional deficiencies. However, an H. pylori infection, which is linked to stomach ulcers, is the most common cause of low stomach acid. 

Other factors that play a role in low stomach acid include hypothyroidism, pernicious anemia, and deficiencies in zinc B12, magnesium, or chloride. People who have been vegetarians or vegans for a long time may be deficient in zinc and B12, which are abundant in meats. 

How low stomach acid causes acid reflux
In order for the small intestine to receive food from the stomach, the contents must be acidic enough to trigger that passage. When this fails to happen, the food shoots back up into the esophagus.

Although the food is not acidic enough for the small intestine, it is too acidic for esophageal tissue. This is what causes the burning of acid reflux, or heartburn.

Why antacids worsen acid reflux in the long run
Antacids or acid blockers bring temporary relief but can cause bigger problems in the long run. Without stomach acid to trigger the release of enzymes, digestive hormones, and emulsifiers, nutrient absorption suffers and the digestive tract is more prone to infection, inflammation, and damage.

How to improve low stomach acid
The first thing to do with low stomach acid is address the root cause. As we age, stomach acid naturally decreases. You can boost stomach acid by taking a supplement that contains betaine hydrochloric acid (HCl). However, if you have stomach ulcers or stomach autoimmunity (when the immune system attacks and destroys tissue), supplementing with HCl could make you worse. In these situations you need to address the existing condition first.

Ask my office how to correct low stomach acid, safely supplement with HCl, and improve overall gut health.  We successfully can remove PPI's without the unwanted withdrawal symptoms that often accompany the discontinuation of them.

 
 
 
 
 

As we age, we sink, we sag and we deflate.  This is due to progressive fat and bone loss, and gravity.  We are left with loss of volume, fallen cheeks, deep nasolabial folds, marionette lines, and heavy jowls.

Dermal fillers and fat transfer are the primary treatment for these complaints.

How are Fat Transfer and Dermal Fillers alike and how are they different?

First, is that fat comes directly from your body and is completely natural.  Dermal fillers although natural in nature must be stabilized so that your body does not rapidly absorb them.  Fat is a particularly good option for someone who might be highly sensitive or allergic in nature.

Fat transfer injections work very similarly to dermal fillers.  Both products will add volume to your temples, cheeks, jawline, and around your eyes, mouth and nose creating a natural more youthful appearance.

The difference between fat transfer and dermal fillers is basically the volume you get to work with.  Dermal fillers typically come in 1-1.5 ml syringes. Although there isn’t really a limitation on the amount one can do, it could become an issue of cost.  One typical fat transfer procedure produces 12-20 ml of fat. Fat transfer becomes a better investment. Not to mention it lasts longer!

Fat Transfer

What is it?
Autologous fat transfer is a simple in office procedure where your fat is used to replace volume elsewhere in your body.  Common areas include face, hands, scalp, penis and vulva.

Who is a good candidate?
Anyone with signs of wear and tear or loss of volume.  Fat transfers help to revoluminze areas such as temple, cheek, lips, deep lines and hollows.  

How is it done
Fat transfer involves taking the fat during a basic sterile procedure using a gentle liposuction to remove fat from your abdomen, thighs or back.  The fat is then decanted leaving only left the fat cells. The final process is then re-injecting it back into the wanted areas.

Ideally this all comes down to choosing what is an appropriate anti-aging treatment for you.  

What is the down time?
You can expect to be sore, swollen and bruised during the first week.  The harvest site is typically more sore than the injection site. Pain is actually rather minimal.  The bruising and swelling reduces usually in the second week and is typically completely gone by the end of the second week.

The harvest site is wrapped in an ace bandage or compression garment post procedure and this is usually worn for several days.  The bruising and soreness usually resolves during the second week.

Dermal Fillers
What is it?
The Dermal fillers that we use are primarily hyaluronic acid and they are used similar to fat to add volume.  Dermal fillers are used on the face and in the hands.

Who is a good candidate?
Anyone with signs of wear and tear or loss of volume.  Dermal fillers help to revoluminze areas such as temple, cheek, lips, deep lines and hollows.  

How is it done?
This is an easily done treatment that involves a topical numbing agent and then small injections into your areas of concern.

What is the down time?
Swelling and bruising are the typical side effects from dermal fillers.  While everyone is different the most common area for swelling is the lips, which can take anywhere from 1-5 days to resolve.  Most of the bruising is easily covered with make-up.

Find the Treatment that fits your needs
As you can see both fat transfer and dermal fillers are more alike than different. The most important feature is that fat transfer is an all natural completely you anti-aging treatment.  

The bottom line is how much product you most like need to satisfy your end results.  If only 1-3 syringes will be needed then dermal fillers may be just the right fit. If you have more volume loss or deep wrinkles or hollow then a fat transfer will serve you best.

It is best to schedule some time with Dr. Barr so that you can discuss what truly bothers you and what course of action you would like.  She can devise a plan that you can be happy with and that will fit your budget now and in the future.

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