Alona Pulde, MD, L.Ac. is a pioneer in the current health care
system as she unites two powerful synergistic healing
approaches-Western medicine with Chinese Medicine. This unique
foundation offers patients a truly holistic approach to their health
care. Dr. Pulde received her Bachelors of Science in Biochemistry at
UCLA, her Masters degree in Traditional Oriental Medicine from
Emperor's College in Southern California and her Doctor of Medicine
degree from Albany Medical College.
Alona
wanted to be a doctor from a very young age yet it was Chinese medicine
that she engaged first. "In my college years I became disillusioned
with medicine for not promoting health and preventive care. At the time
I was volunteering for an AIDS shelter and happened to be working with
an acupuncturist and learning about Chinese Medicine. I was amazed at
how well I resonated with the Chinese Medical Philosophy - a much more
comprehensive modality that focuses on mental, physical, and emotional
well-being. While earning my master's degree in Chinese Medicine my
greatest mentor encouraged me to get my MD as well."
"I
chose family medicine hoping to open some kind of comprehensive medical
center. I entered medical school disillusioned with medicine for not
promoting health and preventive care, yet I was confident that I could
help bridge that gap. My father's sudden death of a heart attack while
I was in medical school was devastating. It made me look at life
differently. Our family had grown up being attentive to our health
using olive oil, eating fish and chicken, exercising, etc. But I was
realizing there is so much more to it. Meeting Matt, and then learning
about T. Colin Campbell and John McDougall, about plant-based
nutrition, opened up a whole new, and yet intuitively familiar, world
for me. It was a relief to read about doctor's working with patients to
truly be well. It is now a most amazing thing to actually see patients
walk in excited about what they are learning, about feeling good, about
making progress. And not just easy patients either, but people with
serious health issues. How can any doctor, after experiencing that,
pursue any other kind of medicine?"
Dr.
Pulde particularly focuses on women's health, pregnancy, hormone
issues, etc.; why Moms may have particular problems with a vegan diet,
plant-based low fat diet, and the like. She says that
epidemiologically, women from other countries do not have the same
hormone issues as women in the United States. Her expertise in
acupuncture is also of great benefit for patients in treating
arthritis, asthma, chronic back pain, common cold, fatigue, gastritis,
headaches irritable bowel, sciatica and much more.
EXSALUS
Drs.
Lederman and Pulde started their practice by providing one day
home-based visits to teach people about nutrition, medical
misinformation, and exercise, among other things. They say it was a
great start but not financially feasible for most people, so they knew
they needed to establish a center and programs that people could
attend. They created the name Exsalus based on the root word Salus,
which is latin for health, then added the prefix Ex for 'complete.'
Exsalus speaks to offering people the opportunity to excel at reaching
their complete health: mind, body and spirit. They offer comprehensive
health care:nutrition education, therapeutic lifestyle modifications
including diet, fitness, as well as emotional and mental well-being, in
a warm, tranquil and healing environment. Dr. Pulde explains: "Our goal
is to spend time with patients, identifying obstacles to health,
addressing concerns and overcoming barriers. Monitored participation
with physician supervision in one of our designed programs tailored to
the individual's need is the ideal for optimum success, yet shorter
personal clinic visits are also available."
HEALTH PROGRAMS
As
patient advocates, Exsalus staff educates patients regarding their
particular medical concern, assists them in recognizing obstacles to
health and works with them to overcome those hurdles regarding issues
from weight to reversing heart disease, to eliminating the need for
medications; i.e. to attaining the vitality they desire, and deserve.
Exsalus' health programs include:
- Two 'intensive' options: Option #1:
Clinic program which includes thorough evaluation by Dr. Lederman or
Dr. Pulde, comprehensive medical history review, detailed diet
analysis, nutrition and lifestyle education, psychological/motivational
support, book and DVD on the benefits of a plant-based diet and
personalized resource binder with tips and strategies for success. Option #2:
Home-based, practical starter kit which includes practical application
by Dr. Lederman or Dr. Pulde, nutrition and lifestyle education,
hands-on help to rid your pantry and refrigerator of unhealthy foods,
learning to read labels, a shopping lesson as to how and where to buy
healthy foods, cooking lesson to demonstrate how easy and tasty healthy
cooking can be. Option 2 does not include any medical evaluation.
- Office Visits
- Massage
- Acupuncture
- Phone Education is done in one hour segments, with the number
of conversations to be determined as needed. Patients need to fill out
a Preliminary Assessment Form in advance of their consult and also
forward any recent blood work and pertinent medical information. Note:
unless first seen by one of their doctors, phone consults are for
educational purposes only and do not include medical advice.
- Cooking Classes address the fact that one of the most
frustrating aspects of changing our diets is feeling limited in the
foods we can get and enjoy. Exsalus Health & Wellness Center is
excited to be offering cooking classes and/or food preparation to turn
that frustration into exhaltation. "We feel that healthy eating and
satisfyingly delicious meals are not mutually exclusive," exclaims Dr.
Pulde. "Keeping your taste buds satisfied and your stomach content is a
key to obtaining and maintaining health. Teaching patients about
healthy substitutes for their favorite foods AND how to prepare these
dishes easily is essential to their success."
- Weekly Group Meetings are another vital component.
"Developing a community of support is essential to success. Community
is the glue that hold together the newfound clarity, confidence and
convenience people have obtained. As such, we encourage them to attend
our weekly meetings to come see old friends or make new ones, share
successes as well as frustrations, learn new recipes and stay
motivated. There is a nominal $5 fee if patient has been through a
program and $15 if they have not."
Exsalus also
offer seminars, lectures and events to stay visible and make their
services accessible. Currently they do not offer 'Group Visits/Digmas'
though they may in the future.
TOOLS FOR SUCCESS
Exsalus
utilizes a Personalized Daily Nutritional Analysis whereby the patient
answers questions such as: Do you need "supplements" in your diet? Are
you worried that you are not getting enough protein? Cost to have an
assessment done is $95 for a full analysis of an average day of meals,
% of Daily Reference Intake (DRI's) met, and how to meet any
theoretical deficiencies with whole foods. They also give patients a
list of potential symptoms of deficiencies and other helpful
informations as appropriate. Patients can find the Nutritional
Assessment Form document on the Exsalus website.
The
Analysis will inform the patient about: 1) What % of the recommended
intake they are achieveing for Vitamins: A, Folic Acid, B1/thiamine,
B2/niacin, B5/pantothenic acid, B6/pyridoxine, B12/cobalamin, C, D,
E, and K; 2) What % of the recommended intake they are achieving for
Minerals: calcium, copper, iron, magnesium, manganese, phosphorus,
potassium, selenium, sodium and zinc; 3) What % of the recommended
intake they are achieving for Fats: Omega 3 fatty acids as well as
their Omega 3 to 6 ratio; 4) What % of the fat the patient consumes is
saturated, mono, poly or trans; 5) What % of the Definitely Safe Intake
(DSI) of each of the 8 essential amino acids they are getting; 6) Total
amount of fiber in their diet; 7) Total amount of calories in their
diet. 8) "Supplement" recommendations-supplementing with foods that are
higher in what they need.
If
a patient is not meeting the recommended daily intake for a particular
nutrient, they are given a list of foods higher in that nutrient and
recommended quantity to meet 100% of the recommended intake, being
clear that recommendations are based on available population studies
and that results should be used strictly as a rough estimate of how
well the person is meeting their nutrition requirements. Exsalus is
clear that unless applicants have a professional doctor/patient
relationship with Exsalus, they should address their specific
nutritional adequacy concerns with their personal physician. Sample
assessments can be found on the Exsalus website.
PROGRAMMED for SUCCESS
"We
offer our LM patients several options from a 2 hour consultation with
the doctor, to our other Health Programs geared for 1, 2 or 3 months
(which includes the 2 hour consultation with follow-up hours from 2 to
6 to 10 respectively.) People need time to learn the new
language/vocabulary of health, learn about nutrition and satisfying
meals, as well address obstacles and receive reinforcement of their
effort," Lederman explains. "Compliance increases with continued visits
and monitoring. Patients who undergo one of our programs get a free
visit one year following completion of that program to monitor where
they are." Patients' initial labs (including Cholesterol, ESR, Vitamin
D, Vitamin B-12, etc.) are drawn on week 0 and then a follow-up panel
at a later date if enrolled in one of the programs. Patient's Optimum
Health Continuum is reviewed each week along with objective data taken
at the clinic: Dietarty compliance, exercise-stretching, flexibility,
resistance; Caffeine, tobacco, sleeping habits, measure of deprivation;
Wt, BP, pulse, subjective energy score.
STAFF
Dr.
Lederman and Dr. Pulde collaborate with independent contractors who are
expert in their field--for cooking classes as well as contractors to
help with public relations and marketing, is vital. Staff notes that
"reaching out to professional societies, local organizations, and other
health practitioners is a must."
MAKING ENDS MEET IS POSSIBLE
As
a fee-for-service facility, Exsalus currently operates on a cash basis,
with the exception of Dr. Pulde's acupuncture services when covered by
the patient's health insurance. In those cases, Exsalus submits
paperwork for the patient. Exsalus does provide a 'super bill' for
patients to submit to their insurance for any lifestyle medicine
services for possible reimbursement. Some patients utilize a Health
Savings Account to maximize their resources. A "Buddy Team" discount is
also available whereby two patients who come together will get 15% off
each for whatever program they sign up for. Dr. Pulde explained
further: "Of course fees vary depending on what service is rendered.
Our main focus is to promote LM and reach as many people as possible.
We therefore offer payment plans and work with patients to make the
fees manageable for them. Our overhead is low so even while starting
off we can make ends meet. Ultimately, once our patients are exposed to
our program, they all feel the money is well worth it!"
PUBLIC RELATIONS/MARKETING
Dr.
Lederman admits that it is not easy to keep getting the word out about
the Center and about people's options for complete health. "People who
do this work are passionate. We continuously offer free lectures-with
healthy snacks, make phone calls, send emails. If you've been taught
all your life that English is a healthy language and then all of a
sudden you are told that a whole new language is what's good for you,
it takes time for people to hear it and embrace it. A health &
wellness center like this can be done; doctors can start to make
changes as to how they serve their patients, utilizing Lifestyle
Medicine, but they have to be really determined, and must be living it
themselves." Lederman and Pulde's book about Exsalus Health Programs is
due out this November. Yet untitled, it is about "Exsalus Health
Program: a quick and easy guide to achieving your optimum health that
provides the foundation needed to lose weight and reverse disease."
UPCOMING DOCUMENTARY
A
documentary based on T. Colin Campbell, John Esselstyn, and John
McDougall's work and the evidence of Lifestyle Medicine, is in
production right now. Brian Wendell is Executive Producer; Lee
Fulkerson is writing and directing it. One of the story lines in the
film is where they tracked Drs Lederman and Pulde and two patients
following their program.
FUTURE OF LIFESTYLE MEDICINE
Dr.
Lederman reiterated the importance of supporting one another in this
work. "Guidance from others in the field of Lifestyle Medicine is
important to the success of each LM practitioner. I look forward to
working closely with ACLM to keep the momentum going."
ACLM Disclaimer: Our Practice Spotlights are intended to
provide examples of Lifestyle medicine in practice. We recognize that
Lifestyle Medicine practices vary widely, and inclusion in Practice
Spotlight is not intended to imply official endorsement of individuals
or practices. 