Kelly Wratten, APRN CNP

My patients will tell you that I spend a lot of time talking about fiber
o there is a huge reason for this.
FIBER IS AMAZING!!
Fiber will positively effect on your appetite, waistline, blood sugar, and overall health t
Soluble fiber can help lower blood sugar, lower insulin levels, balance hormone levels, aide estrogen metabolism, reduce the risk of breast cancer, support the absorption of vitamins and minerals, promote a feeling of fullness, and nourish your gut microbiome for better gut health!!
Due to all its benefits, fiber can greatly improve chronic conditions which in turn helps you just feel better.
How much I recommend my patients consume depends on multiple tactors, but frequently I recommend 30 to 50 grams of fiber daily, particularly the soluble kind found in fruits vegetables f, beans, nuts, seeds, and whole grains. Talk to your P*P about what they recommend.

Most of us know that we aren't suppose to "eat within 3 hours of bedtime."

However, many of us do not really know why.. do you?
Our bodies work in rhythms & cycles, which our often associated with light and darkness patterns. Even our pancreas (produces insulin) gets sleepy when melatonin rises. This means that when the sun goes down, in order to promote sleep and ultimately repair, our melatonin begins to rise. Then ideally, it will stay elevated until you see light in the morning.

That also means that from sundown to sun up, melatonin is inhibiting insulin release from our pancreas. This leads to elevated overnight glucose levels if we choose to eat something that has carbohydrates in it. We can look at it as our pancreas sleeping & not releasing insulin.

This is why I don't advocate eating late or super early.

You may be asking why I am talking about
BPA when addressing seasonal allergies..

IgE cells is what causes our allergy response (immune response). Due to elevated IgE our bodies may react to more irritants. This is why l often discuss environmental/food choices with individuals with allergies. Did you know you can even have inflammation in your esophagus from IgE elevation?? It's true!

So if you have allergies or love someone who does...consider removing some sources of BPA. BPAs are in everything (even clothes) but some things you could avoid are:
- plastic- bottles, storage, etc.
- receipts
• dental sealants
- canned goods that are BPA lined
You likely cannot avoid BPAs entirely, but start with little changes you can make to lower exposure!! Eating your vegetables can help rid the body of BPA as well.

When we are discussing your health & weightloss goals, not only will we discuss protein, but we will discuss your Vitamin D usage as well!

Did you know that an article released in the Journal of International of Sports & Nutrition in 2020, concluded that "vitamin D doses determined from the plasma concentration of 25(OH)D of individuals to match their specific needs can significantly reduce muscle cell damage induced by eccentric exercise."

This means with appropriate supplementation, you will recover quicker from your weighted exercise!

We’ve come so far…yet still so far away

Just reminder, whether you’re diabetic, trying to lose weight, or just wanting to feel better… Protein & Fiber at vital to your body functioning its best.

Patients, if you can stay home today, please do.

The slip-and-fall potential is very high this morning! EMSA says they've already had dozens of slip-and-fall calls today in the metro.

Your driveways, sidewalks, parking lots, and neighborhood areas are skating rinks with a solid glaze of ice. Please be very careful!

This absolutely breaks my heart.
If you know or love someone in healthcare, be kind to them.
They do not want to rush you, they do not want you to feel like you only get a few minutes with them, they do not want you to feel like they don’t care, they do not want you to feel ignored.
What they want is to be able to provide quality care & you know that you’re more than a number.
They want to get more than 10-15 minutes with you. They want to answer questions in a timely fashion. Trust me, that want to help. They would not have gone into healthcare if not.

So many of us find ourselves working from home, taking time from our families, just so you aren’t ignored. We do more with less, we try to make you feel heard in 15 minutes, even if you have multiple unrelated concerns. Have grace with us, as we just can’t.

I’m not going to lie, I’m worried for the future. I’ve been in healthcare for 23 years. People are leaving now after 3-5 years. We cannot sustain the shortage of workers & the demand to see more/do more with less.

Protein & weight loss!!!

Individuals looking to lose weight, should consume 1gram of protein per pound, a day, of their goal weight. That varies to more depending on the type and intensity of activity. It also depends on the type of protein you're eating and when it's consumed throughout the day. Protein can boost weight loss as part of a balanced diet.

Adding more protein to your diet may help you:
1-Stay Fuller Longer. This is due to protein taking longer to digest than other types of nutrients, so it can keep you satisfied for longer. This can potentially help you stave off snacking and cut some calories.
2-Preserve lean body mass. When you increase your daily protein, it can help reduce the collection of dangerous fats in your stomach. Since protein can aide in building muscle (higher amount of protein) it can help you hold onto your lean muscle when losing fat.
3-Needs more calories fo digest protein. When you eat, your body has to burn calories to probably digest/absorb your nutrients
4-Store less body fat. Protein is much harder that carbohydrates or fats, to store as fat. Protein excess won't lead to fat excess, but carbohydrate & fat excess can.

Steve was driving so fast today, his hanky was blown back! On our way to support the one & only Dr. Corey Chamness at her new endeavor 🩷 if you have a high deductible plan, no insurance, or even just wanting a better experience with healthcare; you should look into PHP.
My patients love me as their primary provider, well I love her! 🙌🏼🙌🏼🙌🏼

Whenever people think about weightloss, they don’t always think about how important it is to lower the inflammation in your body!
You can have weightloss without discussing inflammation, but I don’t recommend it.

I have had some patients ask for Semaglutide because their coworker takes it & they no longer have joint pain. One thing that has to be addressed is that the person has less joint pain as they’ve changed their eating habits & are no longer craving sweets.

I am here for you to create lifelong changes. Slow & steady with permanent changes to your lifestyle is the goal. To keep you healthy & feeling good for as long as possible. Sometimes that includes medications, sometimes it does not.

I’ve seen to many women to count who have va**nal & urinary complaints, that don’t realize that their lack of hormones greatly changes the skin intregirty to va**na, va**nal orfice, & surrounding skin. There are treatments, which not only improve quality of life but just may save your life.

“The thing that kills women is recurrent urinary tract infections (UTIs). Did you know that UTIs account for 7 million visits and hospitalizations annually and 25% of all infections in older people? In fact, apparently one third of the total Medicare expenditure is around UTIs. Not preventing UTIs is costing our healthcare system an enormous amount of money and resources.
Did you know we've had safe and effective treatment options for GSM since the 1970s? Vaginal hormones have existed since the 1970s, but we're using them only for pain with s*x and not for GSM. In fact, data show that by using va**nal hormones, we can prevent UTIs by more than 50%. We can save lives using safe, effective, local, low-dose va**nal hormone strategies. And they are safe and effective for all of our patients in pre- and postmenopause.”

'Vaginal Dryness' Can Be Fatal. No, Really. It sounds minor, doesn't it? A urologist connects the dots from a "little va**nal dryness" to a major cause of death in women, and tells you how easy it is to treat.

Patients often ask what company i use for vitamins & supplements. I have 3, in no order.
Kapsulations (local)
Numedica (local)
Thorne Research

I also have websites to the other companies, I will post in the comments.

Questions? Schedule an appointment to talk to your provider before starting any supplementation regimen

KELLY R. WRATTEN - Dispensary | Thorne

Friends without insurance? This may be an option. The plus, I trust her!!

Healthcare doesn’t have to be expensive!

At Primary Health Partners, patients receive unlimited scheduled appointments, in person and virtually. So, no more urgent care visits or waiting weeks for an appointment. The visits are longer, allowing for more comprehensive care. All appointments are covered under your monthly membership fee, so no copays!

We also provide lab work, imaging services, and generic medications at a steep discount.

If you’re looking for better care, then sign up today!

This working momma is BUSY!!! I’ll take all the help I can get. Meet my new assistant.

Breast cancer…

October is breast cancer awareness month, but for those of us who love someone with breast cancer or those who have cancer; we are aware of breast cancer everyday.
I’ve been in healthcare for 23 years. In that time I have had to make that call to several women, I have watched neighbors go through the diagnosis/treatment process, & I have said goodbye to a friend way to early.

So get your screenings. Do not wait for life to calm down. Be your advocate. Find a provider who advocates for you.

How can you achieve a better balance of your glucose? There are ways to help.

*Exercise. Building muscle as well as increasing endurance.

*Focus on a low-refined carbohydrate, higher fat, higher fiber, phytonutrient rich diet. Eating carbs last.

*Ask your Provider about supplements such as Vitamin D, Magnesium, Chromium, omega-3s, Berberine, & ALA. All which can help with optimal glucose control.

*Address chronic inflammation, may be related to food, environment, &/or dysbiosis.

*Use a continuous glucose monitor, can order from different websites, to track which foods/drinks alter your glucose the most.

I once had a doctor say that Sjogren’s is the “Cadillac” of autoimmune. Not sure I agree. The Bcells that “over-clog & attack” moisture making glands effects more than your mouth & eyes.
Sjogren’s increases risk of joint pain, GI issues, lung issues, kidney issues, va**nal issues, & even reproductive issues.
This chronic inflammation can lead to other, serious conditions. Insurances don’t like to cover dental or visual issues under medical coverage; even though dental disease is tried to increased cardiac risk.

So what can you do? I recommend the Mediterranean diet, omega supplementation, tumeric, exercise, & adequate sleep! All of these tools will help lower the inflammation in your body.

“The Sjögren’s mouth is complex and more than “just dry”; it requires special attention and care to help prevent serious implications on your overall health and quality of life.
With dry mouth affecting 93% of patients, oral health is an important topic that affects nearly all people living with Sjögren’s.”

Research has shown that if you eat your carbs last, AFTER your protein & fat, that you actually have a better glucose response.
Why is this important you ask? Well stable glucose levels, meaning no spikes & crashes, is best for optional hormonal/cortisol/metabolic function. When we do not have stable glucose levels, that alters numerous other body functions.

So eating carbs last is just another way to promote stable glucose levels!!!

&fiber

September marks Su***de Prevention Month – a time to remember the lives lost to su***de, the millions who have struggled with suicidal thoughts & the individuals, families, and communities that have been impacted.

While this is a difficult concept some to understand if they’ve never experienced it personally, please know that you are not alone. Please know that your brain can & does lie to you. Your story isn’t over.

Since going part-time at my main job, I’ve started doing 4-8 hours a week utilizing my aesthetics training. If you’d like, you can follow the Instagram for that at kellywratten.fnp

Now that I have some time to resume posting, I hope to become more active agsin on this page. I may not post anything tomorrow as I have work/charts/labs to catch up on; but soon I’ll be back!

I want everyone to know that my amazing coworker is taking a new opportunity which honestly I believe helps to ensure she’s able to spend the time with patients.
If you’ve ever considered direct provider care, you have a high deductible plan, or no insurance at all; than this may be a great option for you.
Obviously, I’m still available for my patients & look forward to providing care.