Run and Eat–Race for the Taste 5K Run to Benefit EPIC Community Services

The first ever Race for the Taste 5K run was this past weekend. We had over six hundred runners and they were amazingly fast!!!! The setting was beautiful Anastasia State Park, where runners had a great view of the ocean as they ran!

The runners then had free admission to the Taste of St. Augustine, where people could sample different food items and vote for their best in category.

Thanks to Dr. Pineau and everyone at Borland-Groover Gastroenteroloy Clinic for being title sponsor. Orthopedic Associates of St. Augustine, Dr. Marema/Koppman and OB/GYN Associates of St. Augustine were other key sponsors, making this Race incredibly successful! I had fun creating and sponsoring the Runner’s bags (Featuring Ask Dr. Vee, your Holistic Medicine Expert). I also had fun (but was stressed to the max) handing out water to the runners during the race!

Local celebs who ran in the race (and were fashionably dressed to boot, and did not sweat at all despite the 84 degree Florida heat) were too numerous to list, but included Bill Abare (former EPIC Community Services President), Dr. Ram Eyyunni, Dr. Ben Pineau (and son, who runs faster than me!) and Dr. Bill Platko.

All proceeds went to EPIC Community Services, which strives to help patients and families battling addiction through Education, Counseling, Intervention and Prevention.

This year I am Vice President of the Board of EPIC Community Services and am getting on the job training from Bev Slough, St. John’s County School Board President and current EPIC Board of Directors President. Patrick Canan, former EPIC President, and local attorney, did not dress up like Elton John, but he was a sponsor of the Taste of St. Augustine.

Patrick of Gypsy Cab (yummy hummus!) and Lorna McDonald of Raintree Restaurant (yummy berry crepes) were there to help St. Augustine become more tasty.

Thanks to all the great restaurants who were there, Patti Greenough and Teresa Andrews who worked tirelessly to make the event successful!

Rebecca Romaine, was EPIC in helping mastermind such a fantastically successful race. Valerie Lee was the water gal–we are already planning on how to improve our water skills for next year (ok, yeah, garbage cans for the water cups would have been an obvious idea. Also, some of the cups were flimsy. Who knew that you had to test run the cups in advance???) Fortunately, Tara Smith-Vighetti and
Renee Wauldron were there to help pour and hand out water cups during the race!

Preparation, preparation, preparation!

Last updated April 28, 2010 by Dr. Vee

Uh Uh Tomorrow is Payday

Photograph Courtesy of Bob Cuthill

Tomorrow is payday and that is difficult in the life of a primary care physician (I’m not trying to get you to feel sorry for me, just trying to explain the realities of being a primary care doctor in 2010).  Can’t make payroll tomorrow.  This has become a frequent occurrence over the past two years as reimbursements have decreased and the number of patients that need to be seen daily has increased.  

The next time you get frustrated with your primary care doctor (not necessarily the case for some specialists, who are reimbursed at much higher rates) because you don’t have enough time with them, and you have had to wait for a long time in the Waiting Room, remember:  Primary Care doctors have to see more patients in a shorter period of time to keep the practice open. 

Medicare, Blue Cross and other companies audit doctors who routinely see (and therefore bill) for longer office visits.  United Healthcare used to routinely, unilaterally, downcode my office visits from higher to lower levels.  They underwent class action suit and had to stop that practice.  In the end, remember that insurance companies want profits (How else can the CEO make $25 million dollars?) and one method is less reimbursement for doctors. 

But doctors are really rich, don’t work hard and make a lot of money, right?  Put yourself in my place.  If you sacrificed your twenties and thirties hanging out 48 hrs at a time in hospitals taking care of incredibly sick patients, would you be willing to earn less than many nurses, podiatrists, dentists and nurse practitioners?  Ask yourself honestly.  Do you expect to be paid for your time?  Or do you work at Wal-Mart for free?  Do you get free food at the grocery store (Ok, food stamps don’t count–hopefully at least your kids get to eat with the food stamps).  How about free gasoline for your car? How about a free car because you are a nice person and don’t want to get paid for working as a waitress. Hmm…you mean you do want to get paid?  And you work harder than doctors?  And how about those hundreds of thousands of dollars in student loans you accumulated trying to become a waitress.  Probably don’t need to pay those back right? 

And when you go to the grocery store, you get free food, right (OK, food stamps for your kids don’t count.  It is important for your kids to eat).  And free gas for your BMW, right?  And your mortgage is free, too, right? 

Anyway, my point is that everyone deserves to be paid for working hard, and should be able to repay their hundreds of thousands of dollars of school loans (My family isn’t wealthy).  I don’t want to pay to be a doctor, which happens frequently. I have to “lend” my office money when I can’t make payroll.  Problem is, I “lent” the office $6000 last week to pay for the credit card bill with vaccines, medical supplies (know how much that table paper and gloves cost???) and my malpractice insurance.  So now I don’t have anything left to “lend” my practice.  And three people who work with me in the office also depend on me to feed their families.  Never thought this is what life as a doctor would be like. 

So the answer has to be see more patients, less time, not fair to patients or to me.  But the way it is in the primary care world.  Oh, and I have tried praying.  A LOT. 


Last updated April 25, 2010 by Dr. Vee

Margin Players–The Shadow of the Pelican

Pictures Courtesy of Joe Marx, President for Life, Chief Financial Officer, Chief Executive Officer, Personal Chef, Soccer Coach for Margin Players

What a perfect oceanfront theater!  Right in the former Marjorie Kinan Rawlings beachhouse.  Written by Dr. Ruth Streeter, starring Ginny Gladu, Ted Gladu, cameo by Rob Steiner.
Last edited by Dr.Vee on April 20, 2010

What an Exhausting Day!

Photograph of Stethoscope Courtesy of Neil Kad

Wow, Busy Monday, with lots of sick people from the weekend needing to be seen.  Patient with hip fracture in the hospital and healthy girl newborn–both doing well!  Reminds me how exhausting it is to listen and really try to help twenty two to twenty five patients a day.  Sometimes their problems are so overwhelming, I come home and feel like my brain can no longer process more information!    But lucky I get to do this every day!

Last updated by Dr.Vee on May 10, 2010

Margin Players–Theater Fun

Photograph Columbus Theater Courtesy of Andy Helsby

Photograph Black Pelicans Courtesy of Ann Golden Asha

Tonight, I acted a play written by a local playwright–who is also a cancer doctor by profession.  Ever noticed that many people like to do something completely different from their jobs?  Like sing, dance, do triathalons? 

For me it is theater–and I had fun acting in this short play.  It was an adaptation of a Marjorie Kinan Rawlings play, The Pelican’s Shadow.  The play showed the parallel between those huge black pelicans found near the Atlantic Ocean and a pompous perfectionist scientist and husband.  Unfortunately, no pelicans flew overhead on cue during the play, but the weather was perfect on the oceanfront theater.  Lots of nice people very involved and knowledgeable about the arts.  Oh, and they can all cook! 

Sometimes it is nice to do something that is completely different than what you do every day in your “real life.”  And if you were successful at what you tried, the endeavor is even sweeter!

Last updated April 21, 2010 by Dr. Vee

Music Enriches our Lives!

Photograph Copenhagen Opera House Courtesy of Eric Keesen
Senator McGovern had a group of friends over to his house to listen to  amazing opera singers from the University of Florida Gainesville.  Food was catered by Gypsy Cab Company.  I love their hummus! 
Senator McGovern had the “last song” and sang from his heart!
The beauty of music–it so enriches our lives!

Last updated April 26, 2010

Lavender and Tea Tree Oil May Cause Breast Development in Young Boys

Lavender and Tea Tree Oils May Mimic Estrogen Effects in Boys

A study published in  the New England Journal of Medicine suggested that the use of topical agents containing lavender oil and/or tea tree oil may cause breast tissue (called gynecomastia) to develop in young boys. This finding was reported by Clifford Bloch, M.D., a pediatric endocrinologist at the University of Colorado at Denver and Health Science Center’s School of Medicine. 

This doctor found that three of his young male patients with unexplained breast development (gynecomastia) had all used lotions, creams, shampoos, styling products or soap with lavender or tea tree oil in them.  Once these products were stopped, the gynecomastia also resolved.

Researchers who conducted laboratory studies at t he National Institute of Environmental Health Sciences (NIEHS), part of the National Institutes of Health (NIH), confirmed that there may be an association between the use of products containing these oils and prepubertal breast development in boys, but cautioned more research is needed.  Large scale epidemiologic studies are needed to determine the association of lavender and tea tree oils and gynecomastia.

Ken Korach, Ph.D., chief, Laboratory Reproductive and Developmental Toxicology at NIEHS confirmed that his laboratory studies confirmed that pure lavender and tea tree oils can indeed mimic the effects of the female hormone estrogen and inhibit the effects of androgens (male hormones).

Interestingly enough, the male and female hormone levels in the three boys with gynecomastia were not changed by their exposure to lavender or tea tree oil. Therefore, Derek Henley, Ph.D., the lead NIEHS author on the study hypothesized that lavender and tea tree oils may be  “endocrine disruptors.”    Endocrine disruptors are agents that interfere with the activity of hormones but not affect the levels of the hormones themselves.  They may alter signaling of the hormones, resulting in abnormal endocrine effects.

Studies are need to decide whether lavender and tea tree oils have the same effects in females or adults.

The National Institute of Environmental Health Sciences (NIEHS),  a part of the National Institutes of Health, supports research to understand the effects of the environment on human health. 


Henley DV, Lipson N, Korach KS, Bloch CA 2007 Prebubertal gynecomastia linked to lavender and tea tree oils. New England Journal of Medicine 365(5): 479-485  

 Photograph of Australian Tea Tree courtesy of J. Brew.

Last updated April 18, 2010 by Dr. Vee


Lose Weight by Increasing Fat Burning Capacity through Exercise

How to  Increase Fat Burning Capacity For Weight Loss 

Long Distance Runner Photographed by Marco Welt


By Kim Miller, Guest Blogger and ACE Certified Personal Trainer

How can we burn a maximum amount of calories in a minimum amount of time? 

A comment from a reader who writes, “You should check the latest research on fat burning. You suggest that long slow distance (LSD) is the way to go for newbies. But that’s not what the new information says.” Well, the reader is correct, but….. read on. 

 Why Not Skip LSD Training and Get Right to the Best Calorie Burns?

If you are new to fitness, or have not been doing cardiovascular exercises such as walking, swimming, jogging, elliptical training, biking etc., then the suggested long slow distance training with minimal emphasis on heart rate intensity is used to build a base of endurance for furthering harder intensity calorie burning zones. Think of this slow long training as a necessary “evil” for furthering fat burning ability. A long slow distance base of training aids in the formation of new life changing habits, primes the muscles, ligaments, and tendons, as well as the cardiovascular system for a lifetime of increased fat burning ability and a speedier anti aging higher metabolism by reducing the occurrence of injuries, as well as the occurrence of premature overzealous training which often leads to failure. 

Fat Burning Zone Explained in Brief 

In order for a muscle to function it needs energy. There are three options that a muscle has to use fuel: 

1 Carbohydrates
2. Fat
3. Protein- only used by muscles under depleted circumstances. Consider carbohydrates and fats as the two main sources. 

When using energy our muscles use a mix of carbohydrates and fats, this is based on a number of factors, one of them being intensity and duration of activity. Fats require more oxygen than carbohydrates to burn. As a result, as exercise intensity increases and less oxygen is available, the body shifts from a fat burning zone to using carbohydrates for energy in order to maintain the activity. This doesn’t however mean that less fat is burned. In low intensity exercise the fat being used is coming from the blood stream and this was traditionally called the fat burning zone. In order to understand the whole picture though, we must look at where the source of the fat being used is coming from. 

Energy Source Paramount in Increasing Fat Burn Ability 

With increased intensity and duration of an activity, the muscles need more oxygen and energy, so our hearts beat faster to get blood to the muscles quicker. In medium intensity long duration activities the blood stream gets overloaded with work, including the job of providing an energy source to the working muscles. When looking to increase our fat metabolism, it’s necessary to get to this point of overloading our bloodstream’s energy sources. By doing this, the overloaded blood stream must turn to its own body’s muscle fat – namely the primary muscle mover’s fat (triglycerides) and glycogen (sugar) stores- which provide energy to the working body. Obtaining a state of moderate intensity training, where the body is working harder and the heart rate is being taxed at a perceived exertion of 6 out of a 10 point scale is when fat burning is amplified beyond just a simple calorie burn. To translate this into a target heart rate, achieve a heart rate of approximately 80% of your maximum heart rate and continue for duration of 20 minutes and preferably 30 – 60 minutes continuously.

How to Figure Target Heart Rate at 80 Percent 

-Take 220 minus your age.
-Multiply this number by .80.
-Your number is your THR for an increased and more efficient fat burning zone 

Fat burning can be optimized further with high intensity interval training. It’s what all the fitness magazines are writing about.  The secret lies in what is called the after-burn. It breaks all the rules applied here, but you’ll see why it’s absolutely necessary in obtaining a lean more muscular look that includes the difficult to diminish waistline. You can do it! Stay tuned and I’ll help you out. 

Kim Miller 

Kim earned a Bachelor of Science degree in Health and Physical Education from Cleveland State University. Kim is a certified personal trainer certified by the American Council on Exercise (ACE).  She is also certified as a wellness coach with Wellcoaches. 

Photograph Courtesy of Marco Welt

Last edited on April 18, 2010