Conversations with Pam
Welcome to the informed discussion!
(CWP) is an open, live Q&A-style discussion that has been offered as a benefit to members of Wellness Forum Health for almost 30 years; hosted by Dr. Pam Popper, an internationally recognized expert on nutrition, medicine, and health.
Seasoned Wellness Forum members casually refer to Dr. Popper as, “Dr. Pam,” or simply, “Pam,” during these relaxed, but disciplined Q&A-style talks. Dr. Pam covers a lot of ground during these sessions, answering questions about anything from colonoscopies and mammograms to green tea and vitamin D. But after 90 minutes, she says her goodbyes while promising to reconvene in two weeks to continue the conversation. Members graciously sign off, by saying, "Thank you, Dr. Pam," "You're the best, Dr. Pam," or "See you next time!” “We appreciate you!" CWP has been a consistent, informative, and very positive space that Wellness Forum Members have relied on for nearly three decades.
Over the years, CWP has become more than just your average Q&A session and is considered by some members to be a time for a little personal development, self-care and education. CWP is not your typical 12-minute discussion with your doctor, but rather a virtual community event where members can go twice a month to have an informed general discussion about health.
CWP is consistent, something to look forward to and after almost 30 years of having these bimonthly informed discussions with her members, Pam decided it was finally time to bring these conversations to life by putting them into print. The CWP book series is meant to expand upon and keep the informed discussions going while sharing them on a larger scale. The Conversations with Pam blog will provide recaps of her discussions, as well as frequently asked questions, and relevant information along the way. We hope you enjoy the content as much as Wellness Forum Members have throughout the years. Cheers to becoming part of our community of informed healthcare consumers!
CWP RECAP:
Welcome to the conversation!
One of the more recent CWP discussions covered a lot of ground. A few of the topics discussed were probiotics, exercise, morning declarations and yoga.
As usual, the Q&A lasted 90 minutes and consisted of general health questions from the audience. We have provided a condensed recap of the discussion below. Please contact us if you want to find out how to participate in the conversation!
INTRO: Pam always has a delightful and organized way of running the show during CWP. Her warm greeting and friendly reminder about maintaining the boundaries set within the discussion create a comfortable atmosphere for Wellness Forum members. CWP is more of an informal educational discussion with colleagues at a local coffee shop, than lecture hall-style discourse. It's relaxing, there's humor and sometimes even a quick visit from Sir Winston, Pam's jet-black Maine Coon cat (who is a celebrity in his own right). While the group refrains from asking questions that are too personal, general questions of just about any nature are fair game. Throughout the conversation, Pam alternates back and forth between live questions from the group, and questions from the write-in that are emailed to her in advance. After a brief intro, it's time to jump in!
Below is a condensed recap from one of the latest conversations.
Pam: Let's kick off our open Q&A with a question from the live group! Who wants to go first?
Member: Hi, Pam!
Pam: Hi!
Member: There are two parts to my question. I wanted to talk to you about probiotics and prebiotics. Why would you use prebiotics sometimes and probiotics other times?
TOPIC 1: Probiotics vs. Prebiotics
Pam: Okay, good question!
You can think of prebiotics like fertilizer for the gut. An example of an ingredient you might see listed on a package insert indicating a prebiotic would be something like fructose oligosaccharides, or inulin. And you have to be careful not to include prebiotics when you’re just beginning to restore your gut.
For example, let’s say you had a raging infection, and you had to take an antibiotic, which made the infection go away, but decreased the beneficial bacteria in your gut. You would start with just a basic probiotic because you don’t want to fertilize what’s there, which may be a little bit more pathogen-heavy at this point because of the cycle of antibiotics you just finished. So, first you would seed with some good bacteria by taking a probiotic, and then maybe two or three weeks down the line you might take some prebiotics to fertilize those good bacteria you’ve built.
Member: Is it possible that some of us should take a probiotic long-term?
Pam: In terms of whether or not to take probiotics for life, we don’t know because there are no studies that have looked at long-term use, and interestingly enough, the studies we have seen, have looked at short-term use and generally show benefit even when the only intervention is the probiotic itself. This speaks volumes because I’m fairly certain that many of the people in these studies taking probiotics aren’t also adopting a health-promoting diet, while simultaneously starting a daily routine of vigorous exercise. The probiotic is usually used as the sole intervention in these studies, and despite that, it still shows benefit.
There are also some people who claim that if you take the probiotics for too long, that causes problems. I haven’t been able to find a study that shows that, and I looked hard when that statement started surfacing, but I can’t find where the preponderance of evidence can validate that claim.
And I am generally very critical of many supplements out there. I have never wanted to be known as someone who places a blanket recommendation on any one supplement. So, my stance on taking a probiotic, for a long time, was to possibly choose to take it for a while, depending upon your individual situation, and then once the gut was restored, I thought maybe you would then discontinue taking it, right?
Then, what changed my mind a little bit around this were the conversations I was having with our Wellness Forum members who had been diagnosed with inflammatory bowel disease (IBD). Some of these members started telling me that they felt better when they took the probiotic and they got worse when they stopped. But then, when they started taking it again, it helped! And it bears mentioning that these were members who didn’t know each other. They had no contact with one another. One was in Australia telling me this, while another one was in France, and then another four people were in the United States, so I started telling other members with IBD about this hoping it might help them choose the right way for them to move forward.
We also have members who do not have IBS that have chosen to stay on a daily probiotic indefinitely because they feel like they’ve done enough destruction to their gut health over the years, that it is probably a good idea for them. This is very much an issue of individual choice. Other than being of the opinion that it might be a good idea for the IBD patient to continue taking a probiotic long-term, whether or not people without an IBD diagnosis should, I really don’t have an opinion on that other than to say that I haven’t found any evidence that there’s any harm from doing it. And I also believe that everyone has to make up their own mind about it.
Member: Okay. Thank you, Pam!
Pam: You’re welcome! Who would like to go next?
Member: I'll go! I’m curious. I’ve been working on my calendar scheduling workout times, yoga, gym time and time on my ski machine. And I’m wondering, since I kind of feel like I am starting over again, how much time spent exercising is too much? I mean, can I do some of them twice, like ski machine and yoga on the same day? How do I schedule this to make sure I am not over-doing it and hurt myself again?
TOPIC 2: Exercise and Morning Declarations
Pam: Good question! First of all, we don’t usually have too much trouble with over-doing exercise so that’s not usually where the problem is. But having said that, you do still have to be careful that you don’t overdo it. The first thing is everybody should have a rest day built into their weekly workout schedule. I always schedule one rest day per week. And some weeks I’ll take two because sometimes I enjoy doing multiple workouts in one day. For example, last month I did a 45-minute workout followed by two hot yoga classes, which ended up being a little more than four hours of exercise. That was a lot! So, I ended up taking a couple days off that week. But there was nothing wrong with me. I didn’t have to take the extra time off because I was decrepit or anything like that. But since I had done a little more than four hours of vigorous exercise in that one day, an extra rest day just seemed like a good idea that particular week. So, do be careful. And if you hurt yourself, it’s less likely to be because you’re doing too much and more likely to be because of your posture or alignment being out of balance. That’s something we'll cover in my virtual yoga series. Posture is so important. So, arching your back or shrugging your shoulders or sticking your rear-end out are all habits that will cause people to end up with an injury.
And when it comes to strength training, one of the biggest ways that you can tell that you might be doing too much is if you’re having to use momentum. For example, if you are doing bicep curls and you’re not able to stand still with good solid posture while doing them, and you’re doing them while swinging or thrusting your body forward in order to curl the weight, that’s not a good sign. That’s a sign that either the weight you're using is too heavy, or maybe your body is just too tired in that moment to do the curls safely. That would be something to watch for.
Other than that, I encourage jumping in and taking massive action by following through with the exercise plan you scheduled for yourself so that you can establish a pattern. The turning point, or when it becomes a habit, is when it starts to feel abnormal and unnatural not to do it, and it bothers you so much that you get it done no matter what.
Member: How long does it take to get to that point?
Pam: It’s different for different people. And remember we talked a lot about this in the Food Over Medicine Bootcamp last weekend. Setting your intention everyday and making that morning declaration first thing by saying out loud what it is that you're going to do, why you are going to do it and keeping that declaration at the front of your mind. You have to continue to remember what you’re doing and why you are doing it because at some point in time it becomes self-reinforcing. And that’s when the journey starts to become fun! When things start happening that you’ve declared for yourself, it proves you have the power to make your life better by declaring what you want, and that's fun, and motivating, and makes it all worth it!
Member: I do have another question about the morning declaration. And I am looking at this in terms of weight status. Am I to write down my current weight status and then keep coming back to it?
Pam: You want to write your morning declaration in present terms, as if it’s already happened. For example, “I am at my optimal weight. I can run a marathon next week. I feel fantastic. All my clothing fits me. I wear a size 8. I look fantastic! My eyelashes are growing back in. I can bench-press half my weight.”
I mean, whatever it is that you want, you put it into present terms. And your declarations do not have to be about diet and lifestyle. I have several pages of stuff that has nothing to do with diet and lifestyle because I've gotten that part down. I’ve already made my diet and lifestyle goals into a habit. So, there’s an infinite amount of stuff that you can use this type of visioning for, and if you say it often enough, and with a great deal of conviction and mindfulness, you will be shocked at what happens.
And by the way, many times, what leads people to take action, and what gets people interested in signing up for this kind of training is that they get tired of declaring, “I’m going to do this,” and then they don't do it. That's usually when the realization sets in that you’re going to need someone to help you get it done. And I know a lot of you are struggling with diet and lifestyle right now. The stuff I struggle with now is different, but at one point in time, that was my struggle, too. I mean, I was always trying to fix myself, and it was always temporary. I always seemed to revert back to the same bad habits. So, I understand the struggle because I went through it myself. And then one day you just wake up and say, “This is it! I'm done living like this!” And that’s when things start to change. And I’m not going to sit here and say it’s not painful because it is! But, you know, the other side of it is that once you get over that barrier, it gets a little bit easier, and a little bit easier until you realize that you went through a change that was so worth it, and you will never go back to the way things were.
Member: Thanks, Pam!
Pam: You’re welcome. Who wants to go next?
Member: Pam, I'll go – I really struggle, especially in my right arm, with tendonitis. Do you have any good ideas about how to help with that? I want to try to do more weightlifting, so I do need to deal with this, but I’m not sure where to start.
TOPIC 3: Hot Yoga
Pam: Yeah! Heat. Hot yoga. Stretching.
Member: Well, I’m in Florida, so…
Pam: Good! Well, you can do hot yoga outside. During the middle of the summer when it’s really hot, I do hot yoga outside in my driveway, up at the lake. It was even warm enough this past Sunday to do hot yoga outside. So, yeah – I would recommend some heat, and stretching is key. And I imagine you’re already eating a health-promoting diet, so you're ahead of the curve there.
But adding yoga into your fitness routine helps stretch out your muscles to counter all the other activities. And everyone’s formula for doing it is a little bit different. For example, I’ve found that I need three hot yoga classes every week to counter my weight training sessions. And I’m pretty active outside the gym, as well. I run, I do yardwork, housework, carry heavy things from point A to point B. There are a lot of different movement patterns experienced daily by people with an active lifestyle. And the yoga classes help to counter all those movements that can sometimes throw your body out of alignment if you're not mindful. But you just need to experiment with what works for you, and how to fit it into your life. And not only can it help to get those muscles stretched out, it's therapeutic for the mind. I recommend doing hot yoga, because the heat really helps to loosen the muscles in order to get them stretched out safely.
Member: Okay – thanks, Pam.
Pam: You’re welcome. Does someone else have a question or a follow-up to this?
Member: Hi, Pam - I’ve got a question.
Pam: Hi there! Sure! Go right on ahead.
Member: I switched to a whole-food, plant-based diet 18 years ago with McDougall, read all the books and cut my cholesterol in half. There’s a lot of heart disease in my family, and many of my family members died in their 60s. Well, I’ve hit 80! I’m healthy as can be. I work out and everything has been great except all of a sudden, I’m all whacked out in my hips. I can barely walk, and I just don’t understand it. This totally blind sighted me. So, as far as my heart goes, I’ve solved that issue, but now I don’t know what to do about my hips. I don’t know what the heck happened.
Pam: So, you have pain in your hips…
Member: Oh, massive. I can barely walk.
Pam: Okay. Do you practice yoga?
Member: You know, I don’t practice yoga. I’ve got to say, I haven’t tried that. But, do you think it will overcome needing a hip replacement?
Pam: If it were me, and I know that you are not me, so you have to decide what is right for you, but I would do everything in my power to avoid having a hip replacement if at all possible. I might even try yoga!
Member: Well, that sounds great, and I’m very active like you. I bike. I mountain bike. Maybe that’s the problem?
Pam: Well, I’m not suggesting that you stop doing those things, but if you’re not stretching in an intense enough, regular setting to counter it, maybe that's the issue. I mean, now that the weather is getting better, I’m going to be a lot more active, running four or five hours a week, weight lifting in the gym and hot yoga. So, my need for yoga will be even greater. I’m 67 and still doing all this, right? And I need the hot yoga to counter all that activity.
One of my former yoga teachers at our hot yoga studio took a three- or four-week trip to India one year, and she spent a couple weeks of her trip at an ashram in a small Indian village. Across the street from the ashram was a yoga hospital where people checked themselves in to be rehabbed with yoga, and good healthy food. She got curious and walked across the street to see what it was all about, and found people were there solving all kinds of problems with yoga. And if you’ve taken my virtual yoga series, you know what happened to me. I was in a 37-car pileup and rehabbed myself with strength-training and yoga. So, it does work!
Member: What about when you look at an X-ray?
Pam: Well, orthopedic x-rays tell you nothing about what the problem is. And we know this because, for example, an x-ray will show a meniscal tear as the cause of pain in the knee, right? But we now have four randomized-controlled trials where there’s a sham surgery group and a real surgery group, and there’s no difference in the outcome for either group. Repair the meniscus, or don’t repair the meniscus. Either way, they all end up in the same place. And so it’s been well-established that those images are worthless. Now, when they can be helpful is when you’ve broken your leg, and they’re trying to get the bone set so that it’s right – you would want an x-ray for that. But if you’re trying to figure out the source of pain and that kind of stuff, it's useless. Many orthopedic surgeons base their surgical recommendations on it, and that usually doesn’t turn out so great for the patient.
Member: Well, it’s interesting because I can feel it and I can barely walk, but I can ride a bike, no problem.
Pam: Yeah – you can feel it, and you know there’s a problem, but what I’m saying is the image isn’t necessarily going to tell you why you’re feeling the way you're feeling. So, maybe you try yoga before having a hip replacement. You know, totally your choice, but it might be worth it for you to try if you're trying to avoid the surgery.
Member: Okay. All right. And you teach yoga, right? I mean, don’t you have a class?
Pam: I have a hot yoga studio here in Columbus, so you’d have to come here to take the live classes, and you could do that. You could sign up for yoga camp with us. But if you prefer not to travel, I also offer a virtual yoga course. Some of the members attending this session tonight have taken it.
Member: Pam, can I jump in?
Pam: Sure!
Member: I just wanted to say that I took the virtual yoga course. I mean, my sciatica was … gosh, I was in tears. I couldn’t drive, the pain was so bad … so, yeah. I took the virtual yoga course, and the pain is pretty much gone. Her yoga course is amazing!
Member: Pam, does it have to be hot yoga, or can it be any kind of yoga?
Pam: I recommend hot yoga because when your muscles are warm, they're more flexible. It's easier to deepen a stretch safely in a hot room, and you can create that at home, as well. You can make a hot room in a small space with a good space heater. It gets pretty nice and warm.
Member: How do I sign up for virtual yoga?
Pam: It’s a four-week course that I’ll be offering two or three times (maybe four) this year. The virtual workshops offered in the series breaks down the mechanics of each pose in four classes, and everyone gets a private class at the half-way mark. After that, you gain access to a private platform where I show people how to do the poses and provide you with the class dialogue so you can do it at home. I think this is the next best way to do it if we can’t be in the same room. And it’s exactly the class that we teach here. If you’re interested just call the office and we can get you all the dates and information.
Member: Great. Thanks, Pam!
Pam: Well, kids - this was fun, but I have to move on to my next class. We’ll do this again in a couple weeks though, all right? Goodbye, everyone! Thank you.
CONCLUSION: A video recording of CWP is always emailed to members on the following business day after the session takes place, so even if you miss the live session, the recording is still made available. Pam always keeps her members in the loop.
