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Starting a weight loss journey in Dallas? When choosing a weight loss clinic in Dallas, consider these 7 important factors to help you navigate the wide range of possibilities with confidence. From reputation to long-term success tactics, Top Notch Vitality's specialized and comprehensive programs will keep you on track. Contact us at https://topnotchvitality.com/7-factors-choose-weight-loss-clinic-in-dallas/ or call on (214) 509-8715.
#dallas weight loss medicine#weight loss clinics in dallas tx#weight loss clinic dallas texas#weight loss dallas#weight loss center dallas#weight loss programs in dallas#weight loss clinic dallas#weight loss clinics dallas#dallas weight loss clinic#weight loss clinics in dallas
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At Body Lounge Park Cities, we understand that each individual has different goals and concerns when it comes to their health. Our clinic is a sanctuary, offering a unique blend of innovative treatments and therapies tailored to meet the unique needs of our clients. We’re proudly serving the residents of Park Cities and neighboring regions, consistently delivering unparalleled wellness services that extend beyond the clinic’s walls. To make an appointment, call the wellness clinic in Dallas TX or use the online scheduling tool today.
Body Lounge Park Cities 6803 Hillcrest Ave, Dallas, TX 75205 972–803–4432
Official Website: https://www.bodyloungeparkcities.com/ Google Plus Listing: https://www.google.com/maps?cid=1762804419657996084
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In a centre for alcohol treatment, the finest location to beat alcoholism.
Today, various individuals drink for changed reasons. Certain individuals just beverage on unique events, while others practice it consistently or a large part of an opportunity to ease pressure. Several people even assistance drinking when a sagacious relationship consummations or when a companion or relative has genuinely died. Since drinking liquor has changed into a tendency for explicit individuals, stopping can be incredibly irritating. Somebody could become subject to alcohol reliance recuperation.
Dealing with those with drinking issue challenges is the supporting of liquor fixation recovery. Since treatment decisions are compelled without their joint exertion, these working environments make a purposeful endeavor to help beasts in sorting out the validity of the circumstance. Picking your friends and family in liquor recovery with faultless timing will unquestionably keep them away from making hazardous sicknesses like compromising new turn of events, liver cirrhosis, or other heart annoys that could incite your end.
Maltreatment of liquor can accomplish a course of action of clinical, mental, and main problems. Enormous issues could connect with issues with your forward looking mind, liver, kidneys, heart, circulatory framework, and so forth. Such an individual is a piece bound to beat their drinking propensities and problems that hurt their bodies expecting that they become mindful of their drinking conduct and the issues it prompts. Whether the bet is as of now extraordinary as of now, it promptly dropped as the propensity for drinking reduced and the probability of looking for treatment to treat the illness broadened.
Liquor misuse can incite a degree of clinical, mental, and main problems. Issues with your forward looking mind, liver, kidneys, heart, circulatory design, and so on could be related with enormous issues. Tolerating such an individual becomes aware of their drinking conduct and the issues it causes, they somewhat will undoubtedly conquer their drinking tendencies and infections that block their bodies. No matter what how the bet is as of now interesting at present, it immediately reduced as the proclivity to drink declined and the probability of looking for treatment for the weight rose.
Recuperation is a grand district known for various things, yet most strikingly for its liquor misuse treatment focus. This office gives top notch comforts, a learned staff, and an obvious setting that may truly keep up with your patients in their excursion to quit utilizing unfortunate substances like liquor. Patients who are really captivating with a drinking issue are suggested private workplaces so their reasoning can progress. There, experts outfit them with a ton of thought. Nearby restorative counsel, the close by experts correspondingly give organizing, cure, detoxification, grouped edifying social affairs, and different affiliations that really help their losses in quickly fixing themselves.
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Efficient methods for weight loss without dieting
Texas’s McKinney is a city where Dallas is 45 miles away from the location. In McKinney, meridian weight and wellness serves weight loss without in-taking any diet. Weight loss program in McKinney can be challenging to follow a traditional diet and exercise routine. Yet there are a few tried-and-true methods that can make eating fewer calories easy. These are useful techniques for future weight loss prevention as well as weight loss:
Plan Your Meals: By setting a 20-minute timer, you can train your body to eat slowly. One of the best habits for weight loss without following a strict diet is this one. Till the bell rings, savor each bite and keep it in your tongue. Smaller servings eaten more frequently provide the body’s satiety chemicals a lot of pleasure. When you eat rapidly, your stomach doesn’t have time to communicate with your brain when it is satisfied. The result is binge eating. You can get checked out by going to a neighborhood medical clinic for weight loss.
Sleep More, Weigh Less: An additional hour of sleep each night could lead to a 14-pound weight loss in a year. Their example demonstrates how easily calories can be reduced when sleep takes the place of useless activity and the normal thoughtless munching. Outcomes might vary from person to person, but sleep might also be beneficial in other ways. Evidences from Weight Wellness in McKinney shows that having less than 7 hours of sleep increases appetite and makes that you feel unusually hungry.
Go for Green Tea: A successful weight-loss plan may also include drinking green tea. According to certain studies, it may temporarily increase the body’s calorie-burning capacity. This effect may be caused by the phytochemicals catechins. You’ll at least receive a hydrating beverage without a tonne of calories.
Bottom Line:
These are a few effective methods to lose weight without diet. You are not alone if you’ve tried a variety of nutrition for weight loss and approaches without much long-term success and feel confused, frustrated, and overburdened by all the contradictory advice out there. We can help, which is wonderful news. We provide a thorough non diet weight reduction and wellness program that might assist you in reaching your objectives.
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Website: https://dallasvitality.com
medical clinic
At Dallas Vitality, our mission is to provide our patients with cutting-edge, non-invasive treatments to help them achieve optimal health and vitality. We are located in Rowlett, Texas and are connected to Xcel Health Club. Our team of experienced practitioners specialize in the use of natural, regenerative and Osteopractic Physical Therapies to provide treatments for a wide range of conditions and ailments led by Russell Darrington, PT.Our services target Erectile Dysfunction - ED, Osteoarthritis, Muscle Pain, Peripheral Neuropathy, Weight Loss, Fitness and BPH Treatments using AWT Acoustic Wave Therapy. Telehealth and home-health appointments now available. We are dedicated to helping you achieve your Vitality and wellness goals.
Phone: 214-466-8658
Address: 6501 Dalrock Rd, Suite 118 Rowlett TX 75089
CLINIC HOURS: Monday 8:00 AM - 6:00 PM Tuesday 8:00 AM - 6:00 PM Wednesday 8:00 AM - 6:00 PM Thursday 8:00 AM - 6:00 PM Friday 8:00 AM - 6:00 PM Saturday By Appointment Only Sunday Closed
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SEMAGLUTIDE WEIGHT LOSS PROGRAM
Our providers at Skin Damsel Aesthetics., are pleased to announce a partnership with Connected Cardiovascular Care Associates, a nationally recognized cardiology and wellness practice in Dallas, Tx, to offer the Semaglutide Weight loss program. “Both of our clinics focus on health and wellness, which improves cardiovascular and overall health, so it was a natural partnership,” says Bernice Das, Founder of Skin Damsel Aesthetics. Offering a safe physician-coordinated program meets the goal of wanting you to lose weight in a healthy, sustainable way.
Who should try Semaglutide?
Adults with BMI > 25 and at least one other weight-related condition such as high blood pressure, elevated cholesterol, or Type II Diabetes.
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Why keeping your sofa, love seat and chairs clean is so necessary
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Having upholstery in your home can be a great source of comfort and style. But upholstery, like any other part of the house, needs regular cleaning and maintenance to stay at its best. That's why upholstery cleaning in Dallas is so important-- it helps keep upholstery looking great while also removing dust, dust mites, allergens and various other particles that can affect air quality.
Upholstery cleaning isn't just about making sure your furniture looks great; it has to do with improving indoor air quality and stopping health problems triggered by dust and allergens. Routine upholstery cleaning in Dallas will help create a healthier environment for you and your family by removing contaminants from upholstered furniture, making it much easier to breathe.
At the same time, upholstery cleaning can stop upholstered furniture from becoming stained or discolored over time. Cleaning upholstery regularly will make sure that furniture looks great for longer and won't need to be replaced as often, saving you money over time.
To ensure upholstery keeps looking its best, it is essential to rely on professional upholstery cleaning in Dallas. Expert upholstery cleaners have expertise and experience in caring for upholstered furniture, ensuring that all dust and stains are removed while protecting the fabric from damage.
Keeping upholstered furniture clean is an essential part of maintaining a healthy home environment. To ensure upholstery keeps looking its best, regular upholstery cleaning in Dallas is the way to go. Investing in upholstery cleaning services can be among the most effective financial investments you make for your house.
The team of upholstery cleaning experts at Dallas Furniture Cleaning are on call to help you maintain a healthy and clean home environment. Call them today to learn more concerning their upholstery cleaning services. With their knowledgeable staff and state-of-the-art equipment, they provide the best upholstery cleaning in Dallas that you can trust. Reach out to them for help keeping your upholstered furniture looking fantastic!
Furniture Cleaning Dallas Dallas TX 75229 (972) 850-2290
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《*♤bella*♤》
is a south korean solo singer,
choreographer and actress under bighit.
she debuted on july 15, 2012 under bighit the name bella at the age of 15 years old. she debuted as a soloist under jyp under jyp but he rejected her on september 5 2011 it was announced thay bella has now left jyp resigned a contract with bighit as a soloist and a cheograher.
bella fandom name: petals
Bella's fandom colors ; light blue, baby pink, baby puple,
stage name; bella
birth name; kim bella rose
birthday; may 7, 2000
zodiac; tauruses
height; 163cm ( 5'4")
weight; 39 kg ( 99 ibs)
blood type; A
instagram; moon_bella19
twitter; offical_bella
facebook: bellaoffical
tiktok: bella_offical
bella facts
- bella was born in south korea
- bella stared training when she is 10 years old
- bella is an ophan. her mother died of a car crash and her father committed sicide
because of the crash, bella lost most of her hearing in her right ear.
because of the loss of her parents and move to the spine whithout her brother. bella suffered with clinical depression, though it hasn't been bad since she moved to bighit.
Bella lived in Spain for 2 years and Doncaster, UK for one Year , and then moved back to Korea at nine.
▪︎she is the sister of the straykids hyunjin
▪︎nicknames》 bighit's princess, bells, the one that big 3 us scared of,Bts's baby, chan's actual baby girl.
she is part of the netflix shows the stranger things and five fee apart,
hobbies; srcolling on social media, watching blogs, creating tiktoks, vinsta lives, making music, dancing, boba tea breakes ,
favorite food; cookies, cookies and cream, mochi, fried rice, tteokbokki, kimbap, dakgalbi, soup noddles, and bibimbap,
favorite Drinks ; plain strawberry smoothi, ice cream matcha with boba, chocolate milk,
on november 12 2020 Dispatch announced that TXT's yeonjun and bella were dating.
bighit. has confiremed the statment.
She created the choreography for》txt blue hour and collaborted with Bts Jhope's for the Dynamite Dance break,
《°She also created choreographt for°》 itzy's Dalla Dalla, icy, and mafia in the morning, twice's more & more Dreak Dance Break, straykids; thunderouse, mei birthday & Dumb Dumb, ateez's Dance like butterfly winds, ciipher's like you, NCT's make a whish, superm's jopping, and many more.
she's allergic to peanut
▪︎she is part of the bighit collab group A.Eon & it's subunit Z.eon
▪︎she trained under jyp for 4 year's and 1 year under bighit
▪︎she was supposed to debut with itzy but, she left before debut.
▪︎ she says that she was imitated by NCT's taeyong when they met.
▪︎she's friends with a lots of idols even though she's lowkey introvert
》 once neon disbanded all of the members went back to their own respective groups,since yeonjun & bella were separated. Bella started at they starved themselves because they promise that " they would should share every meal together even if their can't be in the same room." This leads to Bella leave JYP and joining big hit ( visa ep. 87 )
Out of straykids, Bella is close to felix ( jay Day episode 10)
She was classmates with Seventeen Dino ( vinsta episode 76)
She hates any tea except for matcha tea
she wants to collab with ateez or do a dance cover with them ( jay Day episode 11 ft ateez )
Bella has a collabed with Ateez on monarch and worked on a song with mingi and hongjoon.
she likes to stan txt's taehyun and bts suga and jimin
because she feels short ( vinsta ep 87 )
she has a pet dog and cat named Daisy and max
During the pandemice Bella starded a weekly live
instagram and vlive for all of her fans. she calls it veinsta live.
she friends with stranger things, it, medici (vinsta episode 89)
she stateded that the big 3 are scarded of her as a joke but then the big 3 are actully scard of her ( Veinsta live. ep 4)
Bella is now official MC for the music bank
She stateded that she had a private instagram account to stalk her fans
Bella reailty shows
stranger things
the umbrella acadermy
the untamed
riverdale
The Witcher
The untamed
Teen wolf
Arcane.
13 reasons why
Annie with an e
Young royals
《*♤Bella's movie*♤》
Descendants 1,2,3,
A silent voice
The gray man
Enola Holmes
Five Feet Apart
Home alone
tall girl
Senior year
Harrypotter and the sourcer's stone
A whisker away
Bella awards
2018 emmy awards outstanding short Drama serise 《♤ the umbrellaacademy ♤》
2020 emmy awards outstanding drama series ( Riverdale)
2021 MBC Drama awards|| best supporting actress|| 《 the season's of Blossom 》
2021 KBS {| the best supporting actress || 《 the season of Blossom 》
MTV 2017 || the outstanding person ||《 stranger things 》
Teen choice || best female actress of the year ||《 the riverdale 》
#Bts soloist#Bighit#Kpop soloist#Bts#Everglow#straykids fanfic#Hyunjin#Twice#jeongin#lee know#bang chan#changbin
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What are the best ways to lose weight for beginners in 2022?
Scientists say these nutrition plans have enough evidence to believe they work in the long-term.
1 Mediterranean Diet
Based on the heart-healthy lifestyle of Greece, Italy, Spain, and Portugal, Mediterranean-style diets include healthy fats such as avocados, olive oil, nuts, and fish at least twice a week, plenty of beans, fruit, leafy greens, and whole grains, and even a daily glass of red wine. You can eat cheese in moderation, but limit the red meat to once or twice a week.
2 DASH Diet
The low-sodium Dietary Approaches to Stop Hypertension (DASH) Diet was designed as a way to help people control their blood pressure without using drugs, though a few books have used it as a basis for a weight-loss diet. DASH emphasizes fruits, vegetables, whole grains, and low-fat or nonfat dairy and limits saturated fat and dietary cholesterol.
How it works for weight loss: You will certainly improve your health with this diet, and if you restrict calories while following DASH’s heart-healthy rules, you can lose weight and lower your blood pressure. A recent study found of obese older adults found that those who followed the DASH diet lost weight and decreased body fat, along with many other health benefits. "DASH is one of my favorite diets," says Meridan Zerner, R.D., a dietitian at the Cooper Clinic in Dallas. "You're getting the anti-inflammatory, high fiber, heart-healthy benefits, and if you use a personalized, calorie-limited plan, you can absolutely lose weight."
3 WW (formerly Weight Watchers)
Formerly known as Weight Watchers, this diet company has been around so long, your Grandma probably tried it when she was trying to take off the baby weight. With the newest version, myWW+, you get sorted into a color-coded program that assigns you a certain number of points per day (foods are given points based on calories, saturated fat, sugar, and protein)—you can eat whatever you want within that range. You can also eat an unlimited amount of 0-point foods (most fruits and veggies and lean proteins such as fish, tofu, beans, eggs, and chicken breast fall into this category).
4 Vegan Diet
Going a step further than the traditional vegetarian diet, vegans shun all animal products, including dairy, eggs, and honey. While many choose this lifestyle for ethical or environmental reasons, some people look to the vegan diet for weight loss as well. And with the new era of plant-based meats, going vegan is easier than ever.
How it works for weight loss: Just going vegan won’t necessary help you drop the weight. After all, candy, pasta, and potato chips can all fall under the vegan label without being particularly healthy or low-cal. "If you eat high-quality vegan food, like leafy greens and plant-based proteins, you can lose more weight than either vegetarians or omnivores," says Beaver; studies confirm that those on a plant-based diet have a lower average BMI than those who eat animal products. A 2020 Australian study came to the interesting conclusion that vegans and vegetarians are more likely to stick with the diet over the long run than those on plans such as paleo, because they were motivated by ethical and moral beliefs rather than just weight-loss.
5 Flexitarian Diet
Whereas the vegan diet goes one step beyond vegetarianism, the Flexitarian diet takes it one step back, explains Dawn Jackson Blatner, R.D., nutritionist and author of The Flexitarian Diet. "This is a very pro-plant diet, but it gives you the flexibility to have a hot dog at a ballpark, or to eat some turkey at Thanksgiving," she says. There are no strict calorie limitations, though Blatner's book provides a 5-week plan that provides around 1,500 calories a day.
How it works for weight loss: By filling your plate with more vegetables, fruits, whole grains, and plant proteins, and sticking with the low-cal plan, you can lose weight and improve your health. A recent review found that people who followed a flexitarian diet had lower BMIs and lower rates of metabolic syndrome than people who regularly ate meat.
You can watch the full video on how to lose weight and how to make these techniques recipes. Just apply now. GET $10 OFF
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Things to Consider Before Choosing a Weight Loss Clinic in Dallas
Are you considering embarking on a weight loss journey in Dallas? Choosing the right weight loss clinic is crucial for your success. With so many options available, it’s essential to know what factors to consider before making your decision. In this article, we’ll discuss the key considerations to keep in mind when selecting a weight loss clinic in Dallas.
Understanding Your Goals and Needs
Before you start your search for a weight loss clinic, take some time to reflect on your goals and needs. Are you looking to lose a significant amount of weight, or do you want to focus on specific areas of improvement, such as nutrition or fitness? Understanding your goals will help you narrow down your options and find a clinic that aligns with your needs.
Reputation and Reviews
When researching weight loss clinics in Dallas, pay attention to their reputation and reviews. Look for clinics with positive feedback from past clients and a good reputation in the community. Online reviews can provide valuable insights into the quality of care and services offered by a clinic. Additionally, ask friends or family members for recommendations if they have experience with weight loss clinics in the area.
Expertise and Credentials
It’s essential to choose a weight loss clinic staffed by qualified professionals with expertise in weight management and nutrition. Check the credentials of the clinic’s staff, including doctors, dietitians, and fitness trainers. Look for certifications and memberships in professional organizations related to weight loss and healthcare. Top Notch Vitality, for example, employs experienced healthcare professionals dedicated to helping you achieve your weight loss goals safely and effectively.
Range of Services Offered
Different weight loss clinics offer various services and programs to help you reach your goals. Consider what type of support you need and whether the clinic offers services such as medical weight loss programs, nutritional counseling, fitness classes, or behavioral therapy. Choose a clinic that provides a comprehensive approach to weight loss, addressing both physical and emotional aspects of the journey.
Personalized Treatment Plans
One size does not fit all when it comes to weight loss. Look for a clinic that offers personalized treatment plans tailored to your unique needs and goals. Your weight loss journey should be customized to address factors such as your medical history, lifestyle, dietary preferences, and any underlying health conditions. At Top Notch Vitality, we understand that every individual is different, which is why we take a personalized approach to help you achieve long-term success.
Accessibility and Convenience
Consider the location and hours of operation when choosing a weight loss clinic in Dallas. Opt for a clinic that is conveniently located and offers flexible appointment times to accommodate your schedule. Accessibility is key to staying consistent with your weight loss program and making it a sustainable part of your lifestyle.
Cost and Insurance Coverage
Weight loss clinics may vary in terms of cost and payment options. Before making your decision, inquire about the cost of services, payment plans, and whether the clinic accepts insurance. Some weight loss clinics may offer financing options or accept health savings accounts (HSAs) to help make treatment more affordable.
Conclusion
Choosing a weight loss clinic is an important decision that can significantly impact your health and well-being. By considering factors such as reputation, expertise, services offered, personalized treatment plans, accessibility, and cost, you can make an informed choice that aligns with your goals and needs. Remember to take your time, do your research, and choose a clinic that prioritizes your success and overall wellness.
At Top Notch Vitality, we’re committed to helping you achieve your weight loss goals and live a healthier, happier life. Schedule a consultation with us today and take the first step towards a brighter, healthier future!
Original Source: https://jacobjose.livejournal.com/649.html
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Eight Common Spas as well as the Services
They OfferThere are an entire host of distinct spas now available throughout the Dallas/Fort Worth area to the public at large. The Dallas/Fort Well worth area is fairly large, one of typically the biggest metros throughout the U. S. As Dallasites we are going to often bombarded along with advertising from advertisements, to radio ads, to even trollies in Uptown! One particular common activity involving the well-to-do crowd Dallas is identified for, is always to search for spas for a variety of solutions. We try this regarding a variety involving reasons: workout, in order to get beautiful, to eliminate unsightly hair, to remove wrinkles, to seem younger,spa Sarnia to clean, and rejuvenate to name only a really few. This stated, how do you keep track of what kinds of spas happen to be available, the ones present which services, plus consequently, which gyms you would end up being most benefited by seeking confer with? Under, we review typically the most popular varieties of spas accessible to you, just what their common companies are, and exactly why they could be the ideal choice for your particular needs. 1. Wellness Spas: Wellness spas focus in holistic care, not just giving the assistance to the people while they are usually there, but additionally educating them how to dispense this inner curing on their personal. Common sessions contain summary of yoga in addition to the mind/body network, maximum health, and avoidance of disease. Many of these are in Uptown, close to Mckinney, or Downtown Dallas. Look regarding ads inside the Observer, Envy, or Document City. Should you be in Fort Worth, pick up the Fort Worth Weekly. 2 . not Medical Spas: Healthcare Spas offer a various medical services provided by doctors- which consist of hair laser removal, acne treatments, chemical facials, botox comestic injection injections, and other relevant services. There are many billboards featuring several types of spas alongside Central Expressway inside Dallas. Laser hair removal and Botox comestic injection are two of typically the most used solutions in DFW associated with all the health spas combined. 3. Day Spas: Day spas happen to be seen as a the span of treatment and can connect with several different types of spas offering different services-though often compared to not- every day health spa will refer to one particular that is with regard to the purposes involving pampering. A number of these exist between Dallas in addition to Fort Worth, along I-30 west. I am just sure this is usually to enable them to be noticed from the freeway. 4. Stay Spas or Spa Accommodations: Stay spas or spa resorts consider the types associated with spas where you can keep overnight. The resorts is a part of the hot tub experience, and the spas can vary in the types and character of services provided there. Common stay spas include weight reduction spas, health spas, and rehab doctor offices as stated in this specific articles. The Gaylord Texan in Grapevine has a resort type spa well-known for those browsing Texas. 5. Pamper Spas: Pamper health spas are most likely the just about all common spas generally there are-the ones you may recognize in movies or other multimedia outlets. Pamper gyms do just that-offer their clients a wide range of pampering services and products to make certain that they feel as relaxed and relaxed while possible. Common service include: decadent meals, facials, massages, etc . Some spas specialize in these services, but many have them along with their additional main services. six. Health Spas: Wellness spas-though easily baffled with wellness spas-center on a well being experience that will be holistic and comprehensive-including exercise, healthy food items, meditation, as well as other well being practice. Some may possibly even call this kind of a gym. There are numerous hundred gyms and workout facilities inside the DFW area. 7. Weight Loss Spas: Weight loss spas are typically stay health spas as they require a commitment to the particular weight loss services provided there over an extended period of time-whether it be intended for a weekend or even a week. These clinics focus on supplying exercise and meals regimens that advertise weight loss in the healthy, detoxifying fashion. They may likewise specialize in human body wraps. Again, appear in the neighborhood publications such as G Magazine, or the particular Observer. 8. Treatment Spas: Another variety of spa is really a rehab spa-common to be able to celebrities-which is seen as an offering a refuge through a variety of stressors and addictions. This sort of spa is a stay day spa which incorporates a sense of escape, while in addition ensuring that just positive influences usually are present, while unfavorable ones-such as harmful habits, stress, over work, etc-are not a part of the environment. These eight sorts of spas fairly much encompass the primary offerings of Dallas/Fort Worth, Texas. We are going to not all just cowboy hats in addition to BBQ. Take the break and take pleasure in what this metropolis can give. Business Name: Glass and Pillar Spa Phone Number: 519-337-9998
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A Guide to Outpatient COVID Treatment: Step-By-Step Doctors’ Plan That Could Save Your Life
Recently, Dr. Peter McCullough, MD, of Baylor University Medical Center in Dallas testified to Texas Senate HHS Committee about how mass media and even some government agencies are silencing clinical outpatient evidence for effective treatment of COVID19 and instead push vaccines only (video shown below).
Treatments like those mentioned by Dr. McCullough can be found in sites like https://c19early.com/ but specifically, McCullough refers to the following Appendix to a document published by Association of American Physicians and Surgeons (AAPSonline.org) as an educational resource. It is based on a paper published in American Journal of Medicine (link), by Dr. Peter McCullough and 22 other clinicians (MDs) and researchers (PhDs).
“Seek early treatment and be your own advocate. All of the physicians contributing to this booklet are on the frontlines treating outpatients at the first signs of COVID illness. Studies in the US and many other countries clearly show that patients who are treated within the first 5 days of symptoms have better outcomes using the combination of medications in the algorithm below.”
COVID-19 hospitalizations and death can be reduced with outpatient treatment.
Principles of COVID-19 outpatient care include: 1) reduction of reinoculation, 2) combination antiviral therapy, 3) immunomodulation, 4) antiplatelet/antithrombotic therapy 5) administration of oxygen, monitoring, and telemedicine.
“For the ambulatory patient with recognized early signs and symptoms of COVID-19, often with nasal real-time reverse transcription or oral antigen testing pending, the following 4 principles could be deployed in a layered and escalating manner depending on clinical manifestations of COVID-19-like illness and confirmed infection: 1) reduction of reinoculation, 2) combination antiviral therapy, 3) immunomodulation, and 4) antiplatelet/antithrombotic therapy. Because the results of testing could take up to a week to return, treatment can be started before the results are known. For patients with cardinal features of the syndrome (ie, fever, body aches, nasal congestion, loss of taste and smell, etc.) and suspected false-negative testing, treatment can be the same as those with confirmed COVID-19. Future randomized trials are expected to confirm, reject, refine, and expand these principles. In this article, they are set forth in emergency response to the growing pandemic as shown in Figure 1 .
Treatment algorithm for COVID-19-like and confirmed COVID-19 illness in ambulatory patients at home in self-quarantine. BMI = body mass index; CKD = chronic kidney disease; CVD = cardiovascular disease; DM = diabetes mellitus; Dz = disease; HCQ = hydroxychloroquine; Mgt = management; O2 = oxygen; Ox = oximetry; Yr = year.
The basic groups of prescription medicines and other therapies used in COVID-19:
▪ Combination anti-viral medicines started as soon as symptoms occur ▪ Medicines to decrease inflammation, such as corticosteroids (called immunomodulators)
▪ Anticoagulant therapy to prevent blood-clots that can cause strokes, heart attacks, kidney shut-down, and death.
▪ Non-prescription supportive treatments with zinc, vitamin D, vitamin C, electrolyte drinks such as Pedialyte, and others.
▪ Home-based oxygen support, such as with an oxygen concentrator. These machines are available by physician prescription from home health medical supply businesses and are covered on most medical insurance plans.
I. Antiviral Agents:
These must be started quickly at STAGE I (Days 1-5):
Symptoms include sore throat, nasal stuffiness, fatigue, headaches, body aches, loss of taste and/or smell, loss of appetite, nausea, diarrhea, fever.
These medicines stop the virus from (1) entering the cells and (2) from multiplying once inside the cells, and they reduce bacterial invasion in the sinuses and lung:
▪ *Hydroxychloroquine (HCQ) with azithromycin (AZM) or doxycycline
OR
▪ Ivermectin with azithromycin (AZM) or doxycycline
Either combination above must also include zinc sulfate or gluconate, plus supplemental vitamin D, and vitamin C. Some doctors also recommend adding a B complex vitamin.
Zinc is critical. It helps block the virus from multiplying.
Hydroxychloroquine is the carrier taking zinc INTO the cells to do its job.
An educational resource from The Association of American Physicians and Surgeons (AAPSonline.org) 16
II. Anti-inflammatory Agents - Corticosteroids (“steroids”): Oral and Nebulized.
These are started at STAGE II (Days 3-14) to reduce inflammation, the cause of added damage to the lungs and critical organs. Symptoms include worsening cough, difficulty breathing, chest heaviness/tightness or chest pain.
As inflammation damages the airways interfering with normal oxygen-carbon dioxide exchange, blood oxygen levels drop and people experience loss of focus, drowsiness, confusion, difficulty concentrating, low energy and severe fatigue.
The exaggerated Inflammation response in COVID further increases the risk of blood clots.
Prescription medicines and other support added now to Stage I medicines are: ▪ nebulized budesonide to help penetrate the lungs and reduce inflammation ▪ oral prednisone, methylprednisolone, dexamethasone
▪ colchicine – may also be added to reduce inflammation
▪ full strength adult aspirin 325 mg to reduce inflammation and risk of blood clots ▪ home oxygen concentrator may be needed to improve oxygen levels (requires physician prescription)
III. Prescription Anticoagulants (“blood thinners”):
STAGE III (Day 7 and beyond): Symptoms seen in Stage II intensify. Difficulty breathing becomes extreme, oxygen levels drop sharply, risk of heart attack or stroke increases. At this point, people are critically ill.
The medicines to be added to Stage I and II medicines now include:
▪ Aspirin 325 mg unless told not to take by your doctors
▪ And/or low molecular weight heparin injections (e.g. enoxaparin [Lovenox]) OR
▪ apixaban (Eliquis), or rivaroxaban (Xarelto), or dabigatran (Pradaxa) or
edoxaban (Savaysa) in standard doses for 5 to 30 days
If these added steps do not lead to improvement, or the patient becomes unstable, a 911 call is warranted for ER evaluation and hospital admission so that more aggressive IV medications (such as remdesivir, Regeneron, and others) may be considered, and more intensive ventilation regimens are possible in ICU settings.
IV. Vitamins, Supplements, and Oxygen.
▪ Zinc sulfate, gluconate or citrate. These forms are available in pharmacies, health food stores, and sold online. Zinc sulfate 220 mg provides 50 mg elemental zinc, the recommended anti-viral dose. Zinc in the form of zinc picolinate form is not recommended following reports of liver damage and tumors from studies about 20 years ago. Following these reports, the German Commission E that regulates supplements used in medical practice in Germany banned this form of zinc.
An educational resource from The Association of American Physicians and Surgeons (AAPSonline.org) 17
▪ Vitamin D3, preferable in oil in capsules for better absorption. Recommended doses for anti-viral benefit vary from 5000 IU or more for 5-30 days
▪ Vitamin C with bioflavonoids for antioxidant, anti-inflammatory effects. Dose
recommendations from our contributors vary from 1000 mg (1 gram) once or twice a day up to 4 or more times a day.
▪ A word about quercetin. Some physicians are recommending this supplement to reduce viral illnesses because quercetin acts as a zinc ionophore to improve zinc
uptake into cells. It is much less potent than HCQ as a zinc transporter, and it does
not reach high concentrations in lung cells that HCQ does. Quercetin may help
reduce risk of viral illness if you are basically healthy. But it is not potent enough to replace HCQ for treatment of COVID once you have symptoms, and it does not
adequately get into lung tissue unless you take massive doses (3-5 grams a day),
which cause significant GI side effects such as diarrhea.
Control of Contagion
A major goal of self-quarantine is the control of contagion. Many sources of information suggest the main place of viral transmission occurs in the home. Facial covering for all contacts within the home as well as frequent use of hand sanitizer and hand washing is mandatory. Sterilizing surfaces such as countertops, door handles, phones, and other devices is advised. When possible, other close contacts can move out of the domicile and temporarily stay with others not ill with SARS-CoV-2. Findings from multiple studies indicate that policies concerning control of the spread of SARS-CoV-2 are effective and extension into the home as the most frequent site of viral transfer is paramount.
Reduction of Self-Reinoculation
It is well-recognized that COVID-19 exists outside the human body in a bioaerosol of airborne particles and droplets. Because exhaled air in an infected person is considered to be “loaded” with inoculum, each exhalation and inhalation is effectively reinoculation. In patients who are hospitalized, negative pressure is applied to the room air largely to reduce spread outside of the room. We propose that fresh air could reduce reinoculation and potentially reduce the severity of illness and possibly reduce household spread during quarantine. This calls for open windows, fans for aeration, or spending long periods of time outdoors away from others with no face covering to disperse and not reinhale the viral bioaerosol.
Combination Antiviral Therapy
Rapid and amplified viral replication is the hallmark of most acute viral infections. By reducing the rate, quantity, or duration of viral replication, the degree of direct viral injury to the respiratory epithelium, vasculature, and organs may be lessened. Additionally, secondary processes that depend on viral stimulation, including the activation of inflammatory cells, cytokines, and coagulation, could potentially be lessened if viral replication is attenuated. Because no form of readily available medication has been designed specifically to inhibit SARS-CoV-2 replication, 2 or more of the nonspecific agents listed here can be entertained. None of the approaches listed have specific regulatory approved advertising labels for their manufacturers; thus all would be appropriately considered acceptable “off-label” use.
Zinc Lozenges and Zinc Sulfate
Zinc is a known inhibitor of coronavirus replication. Clinical trials of zinc lozenges in the common cold have demonstrated modest reductions in the duration and or severity of symptoms. By extension, this readily available nontoxic therapy could be deployed at the first signs of COVID-19. Zinc lozenges can be administered 5 times a day for up to 5 days and extended if needed if symptoms persist. The amount of elemental zinc lozenges is <25% of that in a single 220-mg zinc sulfate daily tablet. This dose of zinc sulfate has been effectively used in combination with antimalarials in early treatment of high-risk outpatients with COVID-19.
Antimalarials
Hydroxychloroquine (HCQ) is an antimalarial/anti-inflammatory drug that impairs endosomal transfer of virions within human cells. HCQ is also a zinc ionophore that conveys zinc intracellularly to block the SARS-CoV-2 RNA-dependent RNA polymerase, which is the core enzyme of the virus replication. The currently completed retrospective studies and randomized trials have generally shown these findings: 1) when started late in the hospital course and for short durations of time, antimalarials appear to be ineffective, 2) when started earlier in the hospital course, for progressively longer durations and in outpatients, antimalarials may reduce the progression of disease, prevent hospitalization, and are associated with reduced mortality. In a retrospective inpatient study of 2541 patients hospitalized with COVID-19, therapy associated with an adjusted reduction in mortality was HCQ alone (hazard ratio [HR] = 0.34, 95% confidence interval [CI] 0.25-0.46, P <0.001) and HCQ with azithromycin (HR = 0.29, 95% CI 0.22-0.40, P <0.001). HCQ was approved by the US Food and Drug Administration in 1955, has been used by hundreds of millions of people worldwide since then, is sold over the counter in many countries, and has a well-characterized safety profile that should not raise undue alarm. Although asymptomatic QT prolongation is a well-recognized and infrequent (<1%) complication of HCQ, it is possible that in the setting of acute illness symptomatic arrhythmias could develop. Data safety and monitoring boards have not declared safety concerns in any clinical trial published to date. Rare patients with a personal or family history of prolonged QT syndrome and those on additional QT prolonging, contraindicated drugs (eg, dofetilide, sotalol) should be treated with caution and a plan to monitor the QTc in the ambulatory setting. A typical HCQ regimen is 200 mg bid for 5 days and extended to 30 days for continued symptoms. A minimal sufficient dose of HCQ should be used, because in excessive doses the drug can interfere with early immune response to the virus.
Azithromycin
Azithromycin is a commonly used macrolide antibiotic that has antiviral properties mainly attributed to reduced endosomal transfer of virions as well as established anti-inflammatory effects. It has been commonly used in COVID-19 studies initially based on French reports demonstrating markedly reduced durations of viral shedding, fewer hospitalizations, and reduced mortality combination with HCQ as compared to those untreated. In the large inpatient study (n = 2451) discussed previously, those who received azithromycin alone had an adjusted HR for mortality of 1.05, 95% CI 0.68-1.62, and P = 0.83.23 The combination of HCQ and azithromycin has been used as standard of care in other contexts as a standard of care in more than 300,000 older adults with multiple comorbidities. This agent is well-tolerated and like HCQ can prolong the QTc in <1% of patients. The same safety precautions for HCQ listed previously could be extended to azithromycin with or without HCQ. Azithromycin provides additional coverage of bacterial upper respiratory pathogens that could potentially play a role in concurrent or secondary infection. Thus, this agent can serve as a safety net for patients with COVID-19 against clinical failure of the bacterial component of community-acquired pneumonia. The same safety precautions for HCQ could be extended to azithromycin with or without HCQ. Because both HCQ and azithromycin have small but potentially additive risks of QTc prolongation, patients with known or suspected arrhythmias or taking contraindicated medications or should have more thorough workup (eg, review of baseline electrocardiogram, imaging studies, etc.) before receiving these 2 together. One of many dosing schemes is 250 mg po bid for 5 days and may extend to 30 days for persistent symptoms or evidence of bacterial superinfection.
Doxycycline
Doxycycline is another common antibiotic with multiple intracellular effects that may reduce viral replication, cellular damage, and expression of inflammatory factors. This drug has no effect on cardiac conduction and has the main caveat of gastrointestinal upset and esophagitis. As with azithromycin, doxycycline has the advantage of offering antibacterial coverage for superimposed bacterial infection in the upper respiratory tract. Doxycycline has a high degree of activity against many common respiratory pathogens including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, anaerobes such as Bacteroides and anaerobic/microaerophilic streptococci and atypical agents like Legionella, Mycoplasma pneumoniae, and Chlamydia pneumoniae. One of many dosing schemes is 200 mg po followed by 100 mg po bid for 5 days and may extend to 30 days for persistent symptoms or evidence of bacterial superinfection. Doxycycline may be useful with HCQ for patients in whom the HCQ-azithromycin combination is not desired.
Favipiravir
Favipiravir, an oral selective inhibitor of RNA-dependent RNA polymerase, is approved for ambulatory use in COVID-19 in Russia, India, and other countries outside of the United States.35 It has been previously used for treatment of some life-threatening infections such as Ebola virus, Lassa virus, and rabies. Its therapeutic efficacy has been proven in these diseases. Like, the antimalarials and antibiotics, favipiravir has no large-scale randomized trials completed at this time, given the short time frame of the pandemic. A dose administration could be 1600 mg po bid on day 1, following by 600 mg po bid for 14 days.
Immunomodulators
The manifestations of COVID-19 that prompt hospitalization and that may well lead to multiorgan system failure are attributed to a cytokine storm. The characteristic profile of a patient acutely ill with COVID-19 includes leukocytosis with a relative neutropenia. These patients have higher serum level of cytokines (ie, TNF-α, IFN-γ, IL-1β, IL-2, IL-4, IL-6, and IL-10) and C-reactive protein than control individuals. Among patients with COVID-19, serum IL-6 and IL-10 levels appear even more elevated in the critically ill. As with any acute inflammatory state, early treatment with immunomodulators is expected to impart greater benefit. In COVID-19, some of the first respiratory findings are nasal congestion, cough, and wheezing. These features are due to excess inflammation and cytokine activation. Early use of corticosteroids is a rational intervention for patients with COVID-19 with these features as they would be in acute asthma or reactive airways disease. The RECOVERY trial randomized 6425 hospitalized patients with COVID-19 in a 2:1 ratio to dexamethasone 6 mg po/IV daily for up to 10 days and found dexamethasone reduced mortality (HR = 0.65, 95% CI 0.51-0.82, P <0.001). One potential dosing scheme for outpatients starting on day 5 or the onset of respiratory symptoms is prednisone 1 mg/kg given daily for 5 days with or without a subsequent taper.
Colchicine
Colchicine is a nonsteroidal antimitotic drug that blocks metaphase by binding to the ends of microtubules to prevent the elongation of the microtubule polymer. This agent has proven useful in gout and idiopathic recurrent pericarditis. The GRECCO-19 randomized open-label trial in 105 hospitalized patients with COVID-19 found that colchicine was associated with a reduction in D-dimer levels and improved clinical outcomes. The clinical primary end point (2-point change in World Health Organization ordinal scale) occurred in 14.0% in the control group (7 of 50 patients) and 1.8% in the colchicine group (1 of 55 patients) (odds ratio, 0.11; 95% CI, 0.01-0.96; P = 0.02). Because the short-term safety profile is well understood, it is reasonable to consider this agent along with corticosteroids in an attempt to reduce the effects of cytokine storm. A dosing scheme of 1.2 mg po, followed by 0.6 mg po bid for 3 weeks can be considered.
Antiplatelet Agents and Antithrombotics
Multiple studies have described increased rates of pathological macro- and micro-thrombosis. Patients with COVID-19 have described chest heaviness associated with desaturation that suggests the possibility of pulmonary thrombosis. Multiple reports have described elevated D-dimer levels in acutely ill patients with COVID-19, which has been consistently associated with increased risk of deep venous thrombosis and pulmonary embolism. Necropsy studies have described pulmonary microthrombosis in COVID-19. These observations support the notion that endothelial injury and thrombosis play a role oxygen desaturation, a cardinal reason for hospitalization and supportive care. Based on this pathophysiologic rationale, aspirin 81 mg daily can be administered as an initial antiplatelet and anti-inflammatory agent. Ambulatory patients can be additionally treated with subcutaneous low-molecular-weight heparin or with short-acting novel anticoagulant drugs in dosing schemes similar to those use in outpatient thromboprophylaxis. In a retrospective study of 2773 inpatients with COVID-19, 28% received anticoagulant therapy within 2 days of admission, and despite being used in more severe cases, anticoagulant administration was associated with a reduction in mortality (HR = 0.86 per day of therapy, 95% CI: 0.82-0.89; P <0.001). Additional supportive data on the use anticoagulants reducing mortality has been reported in hospitalized patients with elevated D-dimer levels and higher comorbidity scores.53 Many acutely ill outpatients also have general indications for venous thromboembolism prophylaxis applicable to COVID-19.
Delivery of Oxygen and Monitoring
Because ambulatory centers and clinics have been reticent to have face-to-face visits with patients with COVID-19, telemedicine is a reasonable platform for monitoring. Clinical impressions can be gained with audio and video interviews by the physician with the patient. Supplemental information, including vital signs and symptoms, will be important to guide the physician. A significant component of safe outpatient management is maintenance of arterial oxygen saturation on room air or prescribed home oxygen under direct supervision by daily telemedicine with escalation to hospitalization for assisted ventilation if needed. Self-proning could be entertained for confident patients with good at-home monitoring.
Many of the measures discussed in this article could be extended to seniors in COVID-19 treatment units in nursing homes and other nonhospital settings. This would leave the purposes of hospitalization to the administration of intravenous fluid and parenteral medication, assisted pressure or mechanical ventilation, and advanced mechanical circulatory support.”
youtube
This is the group’s statement on vaccines:
“Vaccines in Development:
Several vaccine models are being investigated for SARS-CoV-2 (COVID-19) including DNA and RNA vaccines. These vaccines take genetic information from other sources that is introduced into the cells. This information includes instructions to produce a SARS2-like viral antigen itself, and the immune system then reacts to it to develop immunity to the virus.
The most important consideration before approving a vaccine for human use is to make sure that the vaccine is safe and effective. Developing safe and controlled infection models for humans normally takes many years of phased testing in the lab and then in humans. Many physicians and scientists have been concerned that vaccine manufacturers, with government support, are speeding up this process in ways that are not allowing adequate time for the usual phased testing leading up to human clinical trials. Two vaccine manufacturers already have voluntarily paused their clinical trials in people due to serious adverse events.
Currently, there are no RNA-based vaccines approved for human use so it would seem prudent to take the time needed to ensure safety. Vaccines for RNA viruses are notoriously challenging and difficult to develop. We still, after all these years since AIDS emerged in the 1980s, do not have a vaccine for the AIDS virus, or the SARS-1 coronavirus that emerged in 2002-2003, and both are RNA viruses.
Several attempts have been made to create vaccines for coronavirus and other respiratory viruses but none of the vaccines have survived the testing phases. The vaccine trials for SARS-1 from 2003, for example, was shut down because it produced autoimmune hypersensitivity reactions when exposed to the natural virus after immunization in animal studies.
Another problem is that the SARS-2 virus has already shown many mutations. Viruses adapt to the environment to survive. Like the flu virus, it is difficult to predict what mutations will occur and circulate around the world each season. A new vaccine must be reformulated to adjust to the changing genetic makeup of the SARS-2 virus.
Even the best vaccines for flu are only about 30-60% effective. Compare that with an effectiveness for improvement ranging from 64% to more than 90% in more than 100 new studies showing early, outpatient treatment with our existing medications described in chapters.
As research on the vaccine continues, safety and effectiveness are of primary concern. The good news is there are very safe and effective early treatments already available as we described in Chapter 3. Clearly, early, home-based treatment has now been so successful and offers so much hope, there is less urgency to have a vaccine.”
You can sign up to receive the full protocol here: https://aapsonline.org/covidpatientguide/ or find the research paper here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7410805/
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Tips to help you lose weight
McKinney, in Texas, is a city that is 45 miles from Dallas. Weight loss without dieting is offered in McKinney by Meridian Weight and Wellness. Weight and wellness program have been created by us for losing your weight. Although while it is not a panacea for health and not everyone needs to pursue it, if you want to feel the healthiest, you may want to aim for weight loss. Here are some pointers to aid with efficient weight loss:
Don't skip breakfast:
Avoiding breakfast will not help you in weight loss. Because of hunger you can be deficient in important nutrients and end up nibbling more frequently throughout the day. Non surgical weight loss in McKinney has demonstrated that eating breakfast promptly helps people loses weight.
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below the cut is all the good stuff about this soft girl.
name: oakley elizabeth grey.
age: 33.
gender: cis female.
pronouns: she/her.
sexuality: bisexual.
neighborhood: summit lake.
occupation: veterinarian.
physical
height: 5′6″
weight: 119 lbs.
hair color: blonde.
eye color: green.
tattoos: n/a.
piercings: ears.
quick facts (tw death)
Oakley Grey was born and raised in Dallas, Texas. Her family knew wealth on both sides; her father had inherited the family fortune built from oil, while her mother had continued the generational career of a surgeon.
When she was old enough, Oakley began volunteering at the local animal shelter and even assisted at the veterinarian office during her final year of high school. When it came time to for college, her application was stacked with creditable references.
Providence Peak University offered a full ride scholarship due to her incredible grades and volunteer work, which was more than she could’ve asked for. During her time in college, she was studies focused. While she wasn’t studying, she was volunteering at the animal shelter or looking for internships to gain hours. It was during the four years she spent at Providence Peak that she made more meaningful connections than she’d ever thought possible.
When it came time for graduate school, Oakley accepted an offer in North Carolina.Two years into graduate school, she lost everything. Her parents were on a small plane when something malfunctioned, causing the plane to come down. Despite the attempts at a safe landing, there was nothing anyone could’ve done to prevent the tragic accident from happening. The two most important people in her life were gone.
Through heartbreak and loss, she pushed forward and finished her program. It wasn’t easy and there were plenty of times she wanted to walk out, but she couldn’t. Quitting wasn’t an option. Through the struggles, Oakley made it to graduation. After, an old professor from Providence Peak University reached out with news of a job opening at the local veterinarian office she’d once volunteered at. With Providence Peak seeming more like home than Dallas would have, she went for it.
Oakley’s been back in Providence Peak for almost three years now. Everything her parents had was left to her. While she’ll never have to worry about financials, her fear of loss is always lingering. If she lets anyone close, she runs the risk of losing them too. Instead, she puts her focus into her career. Part of her wants to use the money left to her for a newer, bigger, and more advanced veterinary practice. There’s always the risk of failure though, which is the only reason she hasn’t tried yet.
wanted connections
neighbor(s)
pet owners that she sees at the clinic
friend(s)
best friend
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