The Hemp Connection:
choices

I recently started to tell a good friend about the antioxidant power of turmeric. He stopped me midsentence.

"What is it with all this antioxidant stuff? First it was pomegranates. Then it was Mongolian gojis. It's something different every day."

(Insert big sigh and eye roll here.)

"Can you even tell me what an antioxidant looks like?"

My friend's reaction verified something I've sensed for awhile now. In our quest to show how much we know about antioxidants, we've thrown long words and catch phrases at the public, to the point where the concept has become nothing more than hype.

It's not long after any concept hits"hype mode" that it becomes passe. And being passe is absolutely not what the average antioxidant should be, to ANYONE.

So, I'd like to answer my friend's question. My answer is somewhat long, but I will do my best to encourage him--and you--to see past the hype that's been flung at all those innocent pomegranates and beets and Indian curries!

Here are ten important things to know about antioxidants.

1. AN ANTIOXIDANT IS LIKE RUSTPROOF FOR YOUR BODY. Oxidation is the natural process of something breaking down over time. On your car, oxidation looks like rust. Oxidation in humans isn't much different; it's somewhat of a biological rusting out process. So an antioxidant, really, is human rustproofing.

2. AN ANTIOXIDANT SLOWS DOWN AGING. This is primarily a blog for women with PCOS. What does aging have to do with that? PCOS is a disease of inflammation, and inflammation is an aging process. If you stand back and look at the big picture, a lot of the symptoms of PCOS are actually indications of an accelerated aging process--arthritis, forgetfulness, poor sleep, diabetes at an early age, premature menopause--I am struck at how many of my clients really present as old people in young peoples' bodies. Just as there really is no cure for the wear and tear on the body of a car that works better than prevention, PCOS needs preventive action. It's about choosing food, activity and lifestyle behaviors that make it easier for your body to stay young. It IS possible to reverse some aging, but it's a whole lot easier to prevent aging before it happens. Making good antioxidant choices every day is an important part of your personal rustproofing plan (PRP).

3. DON'T JUDGE AN ANTIOXIDANT BY ITS SCRABBLE SCORE. This one drives me nuts. Nutritionists tend to be extremely detail oriented, and they seem to have adopted this compulsion to throw dozens of new long words at the public. I am equally as nerdy when it comes to biochemistry, but there is a place for those words. If seeing them in an article isn't inspiring you to put some new and different foods on your shopping list, what's the point?

I don't believe in dumbing down the public, but I have to admit, much of what I read has MY eyes glazing over because how the word was spelled or pronounced was apparently more important to the author than what's in it for me to care.

If you're adding a few beets at the salad bar or learning to cook Indian curries, that's what matters. The chemicals will help you to be healthier, whether or not you can spell or pronounce them.

4. THE BEST ANTIOXIDANTS ARE FOUND IN THEIR ORIGINAL PACKAGING. I graduated from college in 1982, and there were only a handful of antioxidants to learn about at the most. Back then (I guess you could say the nutritional dark ages!) we learned mostly about vitamins and minerals. Many of the compounds we knew about, were extracted and sold as"complete nutritional replacements". Of course, the definition of"complete" was based on our limited knowledge of what food actually contains. They weren't really complete because they did not contain the antioxidant compounds we didn't even know about!

That, for me, was a huge lesson learned, about how much of an expert I can truly be in this field. There will always be things I don't know, and need to know, and my responsibility as a health educator is to be as complete in talking about what I don't know as I do about what I do know.

Therefore, my advice when it comes to antioxidants and supplements, is not to focus on what the most important, most perfect antioxidant might be, then to extract it and consume it in large quantities. Rather, look for opportunities to eat whole foods that are as close to the ground and/or tree when you consume them. The more something is sliced, diced, extracted, powdered, concentrated, the less like nature it is.

Remember, whole is best. There may be important nutritional compounds we have yet to learn about that aren't in those expensive antioxidant supplements.

5. ANTIOXIDANTS ARE COLORFUL CHARACTERS. Your plate needs a variety of colors if it's also going to contain antioxidants. I created this graphic last summer to illustrate the concept. If you're eating lots of reds and blues, and are judicious about which white foods you choose, that's a good start. But remember the greens, yellows, and oranges, too! It's really not that hard to choose colorfully. A plate of food that contains a lot of colors is also attractive. Would you rather have a plate of white fish, cauliflower, and mashed potatoes, or a chicken salad packed with apples, walnuts, and spinach?

Eat patriotically--doesn't matter what country--if you put color on your plate, you can't go wrong.

6. ANTIOXIDANTS LOVE A GOOD PARTY! Antioxidants tend to be more effective in the presence of other antioxidants. In other words, you'll get more bang for your buck out of Compound A if you are also eating Compound B. That's why there is no such thing as the ultimate antioxidant. Just like you have less fun at a party if you act like a wallflower, your"health party" will be a whole lot more worthwhile if you introduce and mingle different compounds.

7. ANTIOXIDANTS LOVE THE GYM. Antioxidants have an interesting relationship with exercise. Exercise, because it raises metabolism, is actually an oxidative activity. However…when you exercise regularly, your body becomes more efficient at storing antioxidants for future use, and then mobilizing them to areas where exercise has raised your metabolism. To get the best advantage out of exercise, it's important to (1) not overexercise, but (2) exercise regularly, and (3) be sure the diet you eat on a regular basis is full of colorful foods.

8. ANTIOXIDANTS ARE HOMEBODIES. When fruits are picked early so they can be shipped to distant markets, they're not allowed to ripen and develop their fullest antioxidant potential. When fruits are processed so they can be stored and consumed through off-seasons, they lose antioxidant power. So while I love blueberries and I appreciate their antioxidant power, they are more of a summer treat for me. Since I live in Arizona, I try to eat lots of citrus in the winter, watermelon in the summer, and to use foods from other areas as occasional treats. Every locality has its specialties. Become familiar with what's in season in your area, and if you travel, experiment with local specialties. A Goji berry is definitely a powerful antioxidant tool, but you can be antioxidant friendly even if your plate was not partially picked by distant farmers on exotic hillsides. Some of your greatest antioxidant friends may be lurking just down the road at your local organic farm.

9. ANTIOXIDANTS SHOULD NOT BREAK YOUR BUDGET. When you eat seasonally, you should also save money. In fact, one of the easy way to know what fruits and vegetables are in season is to look for what is cheap! If you frequent your local farmer's market, what you see at the majority of the stands is likely the local seasonal offering. I like eating seasonally because foods move in and out of my menu and I don't get bored because I'm eating the same thing over and over again. Get to know how seasons affect food availability in your area, and plan menus around that. It is fun, not to mention tasty!

10. THE BEST ANTIOXIDANT OF ALL--IS A PROACTIVE LIFESTYLE. OK, here's a picture of an antioxidant. (A face only a molecule mother could love…) What it looks like isn't as important as what it does. An antioxidant keeps you healthy and young! Any choice you make that creates an imbalance--too much exercise and not enough rest, not enough sleep, an imbalanced diet, poor stress management--puts you at risk of antioxidant deficiency. If you're not making good lifestyle choices and assuming a supplement will absorb the imbalance, you're putting yourself at even greater risk. Be sure your diet has a lot of variety and color.

Even better, apply that mentality to the rest of your life.
--Create a social support network with a variety of personalities that encourage the best in you to come out, and who accept you for who you are without unrealistic expectations.
--Participate in a few different physical activities that allow muscles to rest while others work.
--Do things that make you laugh! (Yes, in a way, your favorite corny movie is an antioxidant!)
--Do something creative.

There are many kinds of antioxidants that have nothing to do with nutrition. Be sure your choices add up to move you in the direction of capitalizing on them, rather than putting you in a position where you need to supplement to reverse damage that didn't need to be done.

OK, good friend, I hope I answered your question and you made it to the end of this blog post without rolling those eyes again!

If you don’t know where you’re going, how will you know when you get there? This post is about following the unknown path, the one that’s scary, mysterious, and potentially full of rewards as well as challenges. There are many gifts, trip-ups, and payoffs to pursue the uncommon option.

There are many known paths – you go to school for a certain amount of time, complete a certain amount of units, and you get a bachelor’s degree. You pass a test, and you get a driver’s license. You say “yes” to the proposal, and you end up getting married. You sign up for a trip, pay your fees, and off you go to Italy. Those things are relatively predictable. There’s a prescribed series of steps, and a pre-ordained outcome.

But what about the rest of it – the pursuit of peace, freedom, wealth, happiness and health? There are a lot of courses that seem predictable that turn out to be not so predictable. You go to graduate school and get a Ph.D. and discover you still can’t get a job. You have unprotected sex for a year, and you’re still not pregnant. You start a surefire business and the concept goes out of fashion before you’re even open. You take all of the prescribed medications, and still your diabetes gets so bad you have to take insulin. You buy a quiet little house in a quirky neighborhood, and discover that it’s not so quiet after all. Then what do you do?

Instead of freaking out and stopping dead in your tracks, I propose that you pause, examine the trip-ups, and then look at the gifts and pay-offs of the experience, and re-orient yourself along a new path. Maybe in retrospect you realize that you didn’t plan adequately, your market research was incorrect, or you were unrealistic about your physical condition and the impact of your chronic disease. These realizations are lessons in how to better prepare yourself for success when you make your next moves.

Take some time to consider the pay-offs of what you’ve done so far, even though, ultimately, you didn’t get the result you were looking for. Maybe you’ve got an education that serves well as background for another profession, you learned a whole lot more about how real estate or entrepreneurship works, or you have gathered information that’s useful to your doctor in helping you chart the best course of action. Maybe you gained new friends who love and support you, or you learned that you really hate being in charge or meeting daily deadlines. Those weren’t the original goals of your project or pursuit, but they’re gifts (pay-offs) nonetheless. Time spent going down “the wrong path” is not necessarily wasted, unless you fail to extract the lessons of your experiences.

The other thing that often ends up feeling like failure is taking the failed outcome and treating it as if it’s a dead-end, instead of a turning off point for the next experience, choice, or path. By continuously reevaluating your choices and experiences, and treating them as valuable information sources, rather than failures, you’ll be able to move forward with more ease, feeling enriched by your experiences, rather than robbed of time or resources.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.

In my role as a health psychologist who specializes in PCOS and other endocrine disorders, I read a lot of material on PCOS, insulin resistance, infertility, diabetes, and other hormonal matters. The more I read, the more I’m aware of the biases in the various camps, by which I mean, these types of messages that populate the media, presented here with my interpretation of the subtext:

• Natural is the only way to go – you’ll destroy your body with birth control pills and metformin (they’re all toxic chemicals!);
• Supplements are the way to go — forget the pharmaceuticals (it’s only 90 capsules a day, but you’ll manage);
• If you would just practice positive thinking, and say enough mantras, you could improve your fertility and have a cute baby just like this (it’s really your fault);
• We should accept our “flaws” as part of our beauty (and damn the women who take advantage of electrolysis, body sculpting, and hair dye);
• If you don’t follow this medical protocol quite strictly for the rest of your life, you’ll end up in terrible condition, with a host of dreadful side effects that will ultimately make your life miserable and then kill you (I’m the doctor, and I hold all the answers, and I’m going to scare you into compliance);
• Low carbohydrate diets are the only solution (chronic deprivation is the way to go);
• PCOS women shouldn’t exercise too much, or they’ll get all bulky and look like men (this is not actually physiologically possible, but it’s a great excuse);
• Exercise is the only thing that really works, and here’s how to do it (never mind that I don’t have PCOS myself, and know nothing about PCOS).

I could go on and on, but you get the idea. There’s a problem with all of these messages, and the problem is, they’re all wrong. There is no one solution that applies universally to all of us. We are each a unique composition of chemistries, ethnicities, weights, ages, and personal points of view. We have access to different specialists and reading materials. We have different beliefs about what works and what doesn’t. We have varying abilities to assess the correctness of scientific or medical data. We have limited finances and time to try every possible potential solution. And we are, quite possibly, exhausted from trying.

Additionally, consider the source. Quite a lot of these messages (picked up directly from my reading, but not attributed, in order to protect the innocent and the not-so-innocent) are presented to us with the intention of selling something – supplements, coaching services, dietary plans, books, CDs, or workshops. There’s nothing wrong with any of those things, by the way, but if the message consistently points in one direction, and it always results in you buying something, it may not be a message you want to heed. This blog tries to present useful information in a way that allows you to make reasonable choices, utilizing commonly available resources, and without pushing you towards any one philosophy, guru, product, or way of thinking. I think that’s a sensible approach.

That being said, we need to respect the choices that our fellow travelers in this PCOS journey are making. If a woman wants to try metformin, or birth control pills, or Spironolactone, or a low carbohydrate diet, and there’s no medical contraindication, let’s support her the best way we can. Don’t present your personal experience as the absolute truth. Offer it as a way of being there for support, or simply to share your experience so she has other “evidence” to consider.

Consider the impact of emphatic statements that “the only” way to produce a baby, or weight loss, or better fasting glucose numbers, is by following your plan. The woman on the other end may not have the time, education, or finances to implement your well-meaning suggestions, and the result on the other end may be a real emotional slam for a woman who’s already feeling fragile and desperate (this is especially true in the fertility/infertility arena).

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at Gretchen@drhousemd.com. You can also follow her on Twitter @askdrhousemd.

“Gretchen, oh Gretchen! It’s Halloween, come on, I’m so tiny, just eat me. You deserve a treat. I’m only here once a year.” Sound familiar when you substitute your own name?

A few M&Ms, an itty-bitty Butterfinger, those adorable little packets of candy corn, or whatever form of cheap sugar it is that you favor are probably calling your name – LOUDLY – right about now. If you haven’t already succumbed repeatedly to the bowls scattered throughout many offices, or sneaking some out of the stash you intend to distribute tonight, or if you didn’t full-on snag an entire bag of your favorites for yourself, which is even now lurking in your desk drawer. I know the drill. You’ve got that guilty laugh, don’t you?

It’s darn near impossible to be perfect around the issue of refined sugar. It’s in everything from the obvious baked goods and candy to the less obvious prepared salad dressings and sauces – even a Chinese stir-fry or some other meat dishes. Many of us set abstinence from sugars as a goal, and/or adhering to a low-glycemic diet. This is a great idea generally speaking. But we’re entering the time of year when treats abound (I’d say treat season pretty well spans Halloween through Valentine’s Day, which is a long time to be totally out of control), and it’s time to get a grip on yourself, and implement a strategy that works. Here are some of my favorite self-protection strategies:

• Don’t buy the stuff – DUH!? If you don’t have it in your house, you can’t eat it. Or at least you’d have to go make a special trip to buy it, which gives you enough time to re-think that idea. Refusal to participate in self-destruction is empowering.

• If you must buy it, buy something you don’t like – personally, there’s no way on earth I’m going to eat gumballs, Twizzlers, or Skittles. If that’s what I’m handing out, it’s ALL leaving the house. Saved!

• Turn down offers quickly – when you’re standing at the receptionist’s counter staring at that giant bowl of toxic sugar, and she pushes some on you like a perfect hostess, quickly excuse yourself by saying you’re diabetic, you’re allergic to chocolate, or whatever else you need to say. This is one occasion where you should feel free to lie. It’s highly likely the embarrassment and potential questioning (“Um, I’m not trying to tell you what to do, but didn’t you say you were diabetic?!) will prevent you from sticking your hand in that very public bowl.

• Buy yourself a real treat – if I’m going to do chocolate, I want it to be European, very dark, very smooth, and preferably kind of expensive. That doesn’t sound like any of the usual Halloween treats, does it? Better yet, buy yourself a non-food item as a reward for your good behavior. Make your calories and your glycemic bumps meaningful, for cryin’ out loud!

I’m all for self-indulgence, but I believe it is best practiced with thoughtfulness and, frankly, dedication. We should PLAN for indulgence, actually. It shouldn’t be random, stupid, or designed to give you a sugar rush followed by a sugar crash, wildly fluctuating insulin levels, and a bad mood (because yes, the sugar crash causes headaches, stomach aches, insomnia, and contributes to anxiety and depression).

In the world of PCOS, you need to make smart choices. I don’t think choosing cheap Halloween candy is a good choice for your mind or your body because it doesn’t make you feel better, bottom line, and I’m all about feeling better, not throwing things out of balance.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at Gretchen@drhousemd.com. You can also follow her on Twitter @askdrhousemd.

Due to some unusual cramping and bleeding, I went in to see my reproductive endocrinologist (RE), who is dually board certified as a gynecologist and an endocrinologist. If you have PCOS, and especially if you’ve ever tried to get pregnant and had a problem doing so, you have probably been referred to a RE. REs have a specialized understanding of the way our hormones affect our fertility, blood sugars, insulin resistance, and other PCOS-related conditions. They treat many PCOS patients, because PCOS is a primary cause of infertility.

One vaginal ultrasound and one pregnancy test later (the doctor and I duly noting that I am well over 40, infertile by all medical definitions, and just about as likely to be pregnant as Mother Teresa), it was determined that there’s a UFO in my uterus! Well, not really, but that’s what it looks like on the ultrasound screen. So, if it’s not a polyp, a cyst, a fibroid, or a baby, what is it?

Cancer comes to mind, and the possibility of cancer necessitated an endometrial biopsy, which is a very uncomfortable procedure in which the tissue in your uterus (the endometrium) is sampled (that’s medical-speak for pulled out in tiny chunks) and sent to the laboratory to be tested. Fortunately, no cancer was found. However, given that PCOS patients are much more prone than average to conditions such as hyperplasia (a proliferation of sometimes questionable looking cells) and endometrial cancers, the recommendation is almost always surgery to remove the tissue, be it a polyp, a cyst, or in this case, something unidentified. I am fortunate to have a highly skilled, aggressive doctor, who knows me and my condition very well, and I agree with this recommendation.

That was the good news, but then I learned the bad news – that my eggs had officially expired. While some doctors question the accuracy of the anti-mullerian hormone assessor, it’s a pretty accurate way to determine whether your eggs are still of use (and to what degree), or if you are pre-menopausal or post-menopausal. No longer having viable eggs was not unexpected, given my age. Nonetheless, there’s an emotional hit to all of this. There is a sense of loss, of unrealized potential, and a need to acknowledge that the door on having a biologically related child, created with my own eggs, has officially closed. At the same time, there is a surprising sense of freedom and relief accompanying this news. Given my personal and family medical history, I no longer have to make an active choice about passing on my genes. With assisted reproductive technology, the doors are open to carrying a pregnancy anytime up to age 53. I just know now for certain that, for me, a pregnancy would mean using donor eggs.

A visit to the RE can be painful or uncomfortable, confusing, enthralling, educational, inspiring, or worrisome – all at the same time. Surgical procedures and testing add to the complex mix of emotions aroused by having a condition or conditions you don’t entirely understand, an equally confusing array of treatment options, time pressures, and a host of medical practitioners, all with their own particular slant on what constitutes your best treatment plan, and why.

For me, that means surgery next month to remove the UFO, continued monitoring of my endometrial condition, and of course, more visits to the RE, especially should I decide to pursue a pregnancy with donor eggs in the future. I like the idea that I still have options, the immediately pressing medical concern is being addressed appropriately, and some aspects of my fertility still offer possibilities. PCOS has a rhythm and a flow of its own, shifting in prominence at various stages in your life and reproductive cycle, and contributes to a mix of emotional experiences. In choosing how to manage your care, your fertility, and your emotions, I hope you too are able to focus on the positive.

If you have not had the opportunity to hear Gretchen's interviews with pcoschallenge.com, please take the time to do so! Gretchen will also be hosting a PCOS expert webinar next Tuesday…to attend please contact www.pcoschallenge.net for more details on how to do so.

You’ve no doubt noticed the onslaught of pharmaceutical company sponsored advertising flooding television commercials and magazine inserts. You can hardly glance at the media without hearing about side effects such as 36-hour erections (okay, we don't have to worry about that one!), loose, oily stools, nausea, cramping, bouts of mania, and unexplained bleeding. These same ads proclaim the medication’s benefits even more loudly – freedom from migraine headaches, depression, obesity, and erectile dysfunction. The message seems to be that there’s a pill to fix anything that ails you. Sometimes it seems like every kid you meet is on ADHD medication, and half your friends are on some form of anti-depressant – and it’s true that these medications are prescribed with far too much ease and far too little deep consideration. Yet on the other side, there’s a backlash from those who claim that the body is a self-regulating mechanism; that diet, supplements, and yoga can cure anything up to and including cancer; and that all drugs (prescription medications) are poisons that disrupt the system.

As a psychologist treating primarily patients who are dealing with a chronic or acute illness or medical condition, particularly PCOS and other endocrine disorders, my interest in pharmaceuticals relates to both the psychotropics (medications used to treat mental conditions) as well as the medications prescribed by my patient’s physicians to address the physical symptoms of their conditions. Very few of us actually want to be on medication, but there’s a special stigma still associated with the medications we use to treat our brains. People report feeling weak, broken, damaged, crazy, and worse when it’s suggested that psychotropic medication might be helpful in addressing their depression, anxiety, bipolar disorder, or other condition. Consequently, they often refuse to try the very medication that provides them with the support they need so that they can really achieve something meaningful in their psychotherapy.

The truth is that the mind and body are inseparable, and many mental disorders have a biological base – there is literally a chemical imbalance in the brain, and it can be helped with medication. Just like insulin helps the diabetic, or synthetic thyroid replaces thyroid hormone for someone with hypothyroidism, medications that enhance neurotransmitter functioning can fill in the gaps in brain functioning. Non-pharmaceutical approaches such as nutrition, supplements, and mindfulness meditation practices can be useful, but are often not inadequate, or work too slowly. They require dedication and persistence to work, and many patients suffering from a period of depression or facing significant stressors may not have enough time to implement these methods. Sometimes the"medication" you need to consider is something non-pharmaceutical — Chinese herbs, Sam-E, or St. John's Wort, for example.

My perspective is that medication can serve as a support for the brain while you’re learning better coping skills, allowing the brain to rebalance, and getting relief from your worst symptoms. Yet we continue to demonize Big Pharma as money-grubbing, disrespectful of natural processes, and potentially harmful when it is true that even natural substances can be harmful or fatal – to the patient who is allergic to peanuts, a taste of peanut butter may be far more harmful than a large dose of a medication, and in fact, it’s medication that may save that person’s life. For me personally, medication is always a last resort (unless I've got a serious infection, or acute pain, in which case, I say"bring on the meds — and pronto!"). If my clients are stable enough, I also support their trying other things first. But I feel like Big Pharma's part of my tool box — there when you need it, and I'm quite grateful for it when it lifts someone out of a long-term depression, alleviates suicidality, or decreases life-disrupting levels of anxiety.

Similarly, with pain, the old way of thinking is that you should suck it up, suffer, power through – anything but take painkillers. As it turns out, your body heals faster, your anxiety is lower, and there’s a lower incidence of depression when patients take painkillers as prescribed. For a limited time and a specific use, doesn’t it seem reasonable to use every tool at your disposal? I want my patients to feel better sooner rather than later, so we often have discussions about their ideas about taking medication, whether it’s for a medical or psychological condition. If you automatically reject the idea of medication, especially the psychotropic medications, I invite you to examine your attitudes to see if they’re outdated, impractical, self-destructive, or just flat-out wrong. As always, I advocate taking a proactive stance as a patient, whether that’s in your doctor’s office or the psychotherapist’s consultation room. Perhaps you’ll find that the enemy of wellness lies more within your own mind than in the face of Big Pharma.

Gretchen Kubacky, Psy.D. is a Health Psychologist in West Los Angeles, a member of the inCYST Network, and a frequent speaker and author on issues related to health psychology, women's health, PCOS, and other endocrine disorders. If you have questions for Dr. Gretchen, have a topic you'd like to suggest, or would like to learn more about her practice, please visit her website at www.drhousemd.com.