Angie Scala, Author at Donaldson Plastic Surgery

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By Angie Scala |

How Do I Get Better Sleep?

The Core Pillars Of Healthy Sleep Hygiene 

How Do I Get Better Sleep?

Sleep plays a vital role in both mental and physical health, influencing everything from cognitive function, to immune system strength, to our ability to perform at the highest level each day. A consistent sleep routine is fundamental for achieving long-lasting, restorative rest — and the swath of positive health benefits that come with it.

By adopting tailored sleep hygiene practices, patients can improve their overall well-being and healthspan.


 

What Does A Good Sleep Routine Look Like?

  • Limit Blue Light: Refrain from using electronic devices at least an hour before bed to alleviate the negative impact of blue light on melatonin production.
  • Set The Right Temperature: Maintaining a cool room temperature enhances the body’s natural ability to achieve deeper sleep stages. The ideal range is from 65–68°F, according to the Sleep Foundation.
  • Establish a Consistent Sleep Schedule: Go to bed and wake up at the same time every day to harbor a stable circadian rhythm, ensuring consistent, high-quality sleep.
  • Reduce Caffeine Intake: Avoid consuming caffeine in the afternoon and evening, as it can interfere with the natural sleep cycle and delay the onset of sleep.
  • Minimize Noise & Light: Use blackout curtains and white noise machines to curate an environment conducive to uninterrupted sleep.
  • Perform Regular Physical Activity: Engage in regular exercise, which not only promotes overall health but also enhances sleep quality by reducing insomnia symptoms.
  • Create a Relaxing Bedtime Routine: Implement calming activities like reading or meditating to signal to your body that it’s time to wind down, which can significantly improve sleep onset.
  • Avoid Heavy Meals Before Bed: Refrain from eating large or heavy meals close to bedtime to prevent discomfort that can disrupt sleep.
Snacks that won't disrupt sleep

What Time Should I Stop Eating Before Bed?

To optimize digestion and minimize sleep disturbances, it is recommended to stop eating about three hours before bedtime. This allows your body to complete the digestive process, reducing the likelihood of discomfort, acid reflux or indigestion that can disrupt sleep.

If you do get hungry before bedtime, try to avoid spicy foods and carbohydrate-rich foods like bread, chips and dried fruits. Instead, reach for protein-rich options like turkey, chicken, almonds, fish and cottage cheese.

What Time Should I Start My Sleep Routine?

Initiating your sleep routine 60 to 90 minutes before your desired bedtime is ideal. This window allows your body and mind to transition from wakefulness to a more relaxed state, making it easier to fall asleep. Activities during this time should be calming and devoid of stress, supporting a seamless transition into sleep.

What Supplements Actually Help With Sleep?

  • Magnesium: Supports muscle relaxation and nervous system function
  • Collagen: Contains glycine — an amino acid responsible for calming the central nervous system and regulating body temperature during sleep
  • Valerian Root: Offers a calming effect that may alleviate mild anxiety and promote sleep onset
  • CBD: Reduces anxiety, alleviates minor pain and promotes relaxation
  • GABA: Calms the nervous system and has been shown to help reduce anxiety
  • Vitamin D: Regulates the natural production of melatonin; a Vitamin D deficiency can cause sleep disorders
  • Melatonin: Regulates the sleep-wake cycle
Collagen Supplement

Can I Become Dependent On Melatonin?

Melatonin is a natural hormone that can be beneficial for long-term use at low dosages (up to 6 mgs). However, dependency can develop if used improperly or for extended periods. Over-reliance on melatonin supplements can lead to reduced effectiveness over time.

It is best to address the underlying causes of sleep concerns instead of relying on a supplement to mask the issue. It’s essential to use melatonin responsibly and consult with a healthcare provider for long-term sleep issues.

The Far-Reaching Benefits Of Consistent, Good Sleep

  • Enhanced Cognitive Function: Consistent sleep improves memory, attention and problem-solving abilities by allowing the brain to consolidate and process information.
  • Mood Regulation: Quality sleep helps stabilize mood by balancing neurotransmitters, reducing the risk of anxiety and depression.
  • Strengthened Immune System: Adequate sleep bolsters the immune system, making the body more resilient against infections and illnesses.
  • Lowered Risk of Chronic Diseases: Regular, restorative sleep is linked to a reduced risk of heart disease, diabetes and hypertension.
  • Improved Metabolism: Sufficient sleep regulates appetite-controlling hormones, supporting a healthy metabolism and aiding in weight management.
  • Optimized Physical Performance: Consistent sleep enhances physical performance by promoting muscle recovery, endurance and overall energy levels.

The Impact Of Sleep On Hormones & Weight Loss

Sleep directly intersects with hormonal balance, particularly hormones that regulate hunger and metabolism. Poor sleep can lead to disruptions in these hormones, contributing to weight gain and difficulty in losing weight. Implementing a consistent sleep routine can optimize hormone function and support weight management, emphasizing the profound connection between sleep and overall health.

Angie Scala discussing how functional medicine can help a patient get better sleep

What Happens If I Still Don’t Feel Well-Rested?

If you are doing everything “right,” but still cannot sleep or don’t wake up feeling well-rested, there’s a chance something else is going awry under the surface. A functional medicine doctor can help you get to the root cause of your fatigue and nightly disruptions before delivering a comprehensive lifestyle plan to improve your sleep.

It could be diet. It could be hormones. It could be an underlying condition you never considered. A functional medicine specialist will take the time to ask the right questions and perform the most effective tests to fully understand your medical situation.

Why Functional Medicine Over A Sleep Specialist?

Somnologists and sleep specialists perform incredible work. However, they are often hard to reach and their schedules are booked out months in advance. Functional medicine complements their efforts by potentially ruling out certain disorders and deficiencies before referring you to a sleep disorder specialist and opting for a more intensive sleep study.

Many patients find that their primary sleep concerns can be addressed through lifestyle interventions instead of using cumbersome solutions, like CPAP machines, to address symptoms.

What Is Functional Medicine?

Common Causes For Sleep Disorders Include:

  • Allergies: Chronic or seasonal allergic reactions can lead to nasal congestion and irritation, disrupting breathing and causing fragmented sleep.
  • Bruxism (Teeth Grinding): Bruxism can lead to frequent awakenings, jaw pain, and discomfort, disrupting the natural sleep cycle. Botox may be employed to temporarily reduce teeth grinding.
  • Respiratory Issues: Conditions like asthma or sleep apnea can interfere with normal breathing patterns during sleep, leading to frequent awakenings.
  • Genetics: Certain sleep disorders, such as restless legs syndrome, can be inherited, making some individuals more susceptible to sleep disruptions.
  • Nocturia: Frequent nighttime urination interrupts sleep cycles, often leading to insufficient rest and daytime fatigue.
  • Chronic Pain: Persistent pain from conditions like arthritis can prevent comfortable sleep positions, leading to sleep disturbances.
  • Mental Health Disorders: Conditions such as anxiety or depression can alter sleep patterns, making it difficult to fall asleep or stay asleep throughout the night.

 

About The Author

Angie Scala, NP, is a functional medicine specialist in Columbus, Ohio. She routinely works with patients to discover the root cause of their most pressing concerns and designs long-term, lifestyle plans that help improve their daily lives. Angie is dedicated to discovering solutions that impact real people — from optimized sleep routines, to balancing hormones, to restoring ideal gut health.

Angie Scala, Functional Medicine Expert in Columbus Ohio

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By Angie Scala |

Exercise For Fertility Improvements

Movement Is Key When Optimizing Fertility & Overall Wellness

Exercise For Fertility Improvements

Movement helps move oxygenated blood to essential reproductive organs, positively impacting mental health, decreasing stress and eliminating toxins from the body. Certain exercises are more beneficial depending on where you are in your cycle. Focused workouts can be helpful with improving hormone balance, supporting ovulation and ultimately optimizing fertility.

Days 1-5: Menstrual Phase

During the menstrual phase, the body is shedding the uterine lining, leading to lower energy levels and potential discomfort. The focus should be on slower, more relaxed exercises.

Recommended Activities:

  • Stretching: Gentle stretching can alleviate cramps and improve blood flow.
  • Outdoor Walks: Fresh air and light activity can boost mood and energy levels.
  • Yoga: Focus on restorative and gentle yoga poses to promote relaxation.
  • Bodyweight Strength Exercises: Light strength training without weights can maintain muscle tone without overexertion.

Days 6-14: Follicular Phase

As the body moves into the follicular phase, hormones like estrogen and testosterone start to rise, leading to increased energy and strength. This is an ideal time for more intense workouts.

Recommended Activities:

  • Cycling: Excellent for cardiovascular health and leg strength.
  • Jogging: A good balance of cardio and endurance training.
  • Resistance/Weight Training: Builds muscle and bone strength, ideal during this hormonally supportive phase.
  • Pilates: Strengthens core muscles and enhances flexibility.

Days 15-20: Late Follicular & Ovulation Phase

With ovulation comes a peak in energy levels, driven by the highest levels of estrogen and testosterone. This is the time for high-intensity workouts, but moderation is key to avoiding overexertion.

Recommended Activities:

  • HIIT (High-Intensity Interval Training): Engage in HIIT for 30-60 minutes (maximum) over these five days to boost cardiovascular health and metabolism.
  • Running: Capitalize on high energy levels with longer or faster runs.
  • Weightlifting: Continue to build strength with heavier weights or more intense sessions.
  • Swimming: A full-body workout that’s easy on the joints.
  • Sculpt Yoga: Combines strength and flexibility training for a balanced workout.

What Happens If I Push Myself Too Far?

Those trying to conceive must be mindful of the type and intensity of their exercise. Over-training (>60 mins of intense exercise/day) can have a negative impact on fertility due to an increased risk of anovulation (cycles without ovulation). Listening to your body is crucial — adjust the intensity and type of exercise as needed to ensure you are supporting (not straining) your body through its natural cycles.

Days 21: Bleeding / Luteal Phase

The luteal phase sees a rise in progesterone and a second peak of estrogen, often starting with continued high energy, tapering off as menstruation approaches. Adjust your exercise routine accordingly.

Early Luteal Phase Activities:

  • Incline Walking: Low-impact cardio that’s easy on the joints.
  • Dance: Fun, energetic, and great for cardiovascular health.
  • Spin Classes: High-energy cycling sessions that maintain fitness levels.
  • Jogging: Maintain your running routine at a comfortable pace.

Late Luteal Phase Activities:

  • Walking: Gentle, consistent exercise to maintain activity without straining.
  • Hiking: Enjoy nature with low-impact, moderate-intensity exercise.
  • Yoga: Focus on restorative and gentle flows to reduce stress and prepare the body for the menstrual phase.
  • Low-Impact Cardio: Swimming or elliptical training to maintain fitness without high stress on the body.
  • Stretching: Enhances flexibility and reduces muscle tension.

About The Author

Angie Scala, NP, is the holistic fertility specialist at Donaldson. She uses exercise and movement with consideration to the menstrual cycle to support women along their fertility journeys. With each of her patients, Angie focuses on aligning physical activity with the body’s natural hormonal rhythms, adapting workouts to each phase and providing vital nutrition education during this sensitive time.

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The Connection Between A Mother-To-Be’s Nutrition & Egg Quality

It may not feel like it at times, but fertility involves more than just timing and luck. The quality of reproductive cells plays a crucial role in the journey toward conception and healthy pregnancy, with emerging research suggesting that nutrition can significantly impact egg quality. We are diving into this fascinating relationship, uncovering key dietary factors that can boost fertility potential and maximize your chances of conception.

How Diet Affects Fertility

Maintaining A Healthy BMI Has Trickle-Down Effects

Optimally, a patient will want to stay within the BMI range of 18.5 and 25 before their pregnancy. There is a higher correlation between infertility and issues maintaining pregnancy for BMIs that are over or under that range.

Patients who are overweight may run into issues such as insulin resistance, higher cholesterol and other comorbidities that tend to go hand-in-hand with obesity. These all can further complicate fertility. Underweight patients run the risk of facing nutritional deficiencies and malnourishment — or simply not getting the vitamins and minerals needed to maintain a pregnancy.

“You really want to start this process 3-6 months ahead of conception. This gives you enough time to make internal cellular changes. If you want to get pregnant in the fall, it would be best to start changing your diet at the beginning of July.”

The Target Benchmark Changes With Pregnancy

When you’re actually pregnant, the goal is to be within 25 – 35 lbs. of your pre-pregnancy weight to support a healthy pregnancy. Gaining a little bit more weight is healthier than being underweight because you’re not putting the baby at risk of pre-term labor and other issues with birth.

Which Nutrients Can Improve Fertility?

Proper nutrition is pivotal for laying the foundation for robust egg quality. Recent studies support the significance of antioxidants and omega-3 fatty acids, among other essential elements, when optimizing for fertility. These nutrients not only fortify egg health but also establish a fertile ground for conception.

By incorporating foods teeming with antioxidants, omega-3 fatty acids, proteins, nuts, seeds, olive oil and whole grains, this dietary pathway strives to give the body the fertility-boosting vitamins and nutrients necessary for nurturing the delicate journey of conception.

Folate Intake & Healthy Neural Tube Development

Polyunsaturated fats, fiber and plant-based foods are all excellent when it comes to bolstering egg quality, but one nutrient that can’t be overlooked is folate. Folate is especially important during pregnancy to help with neural tube development. Leafy greens, whole grains, fresh fruits, beans and sunflower seeds all naturally contain folate. Folic acid is the synthetic form of folate and is often taken as a supplement or added to food during production..

The Fertility Benefits Of The Mediterranean Diet

Embracing a diet rooted in the principles of the Mediterranean diet, renowned for its anti-inflammatory properties, has emerged as a promising avenue to bolster fertility according to studies encompassing both animal and human models. An optimal balance of protein, carbohydrates, antioxidants, folate and lipids within the daily regimen contributes to the broader canvas of female reproductive well-being.

Necessary Medical Testing To Gauge Your Current Health

Functional stool tests, food sensitivity tests or a cycle on the Elimination Diet are helpful in determining potential causes of inflammation, hormone or blood sugar dysregulation, and weight gain — all of which are potential contributors to suboptimal fertility.

The Importance Of Optimizing The Gut Biome

Maintaining a healthy gut microbiome (an ecosystem of the gut comprised of billions of microorganisms) is a key component to supporting fertility. Supporting the microbiome consists of eating a diverse diet (“Eating The Rainbow”). This involves increasing your intake of fiber, prebiotics and probiotics.

Fiber Rich Foods Include:
  • Avocadoes
  • Beans
  • Dried fruits
  • Legumes
  • Leafy greens
Prebiotic Foods Include:
  • Flax
  • Soy
  • Whole grains
  • Garlic
  • Bananas
Probiotic Foods Include:
  • Kombucha
  • Kimchi
  • Sauerkraut
  • Kefir
  • Yogurt (unsweetened/without added sugar)

What Foods Damage Egg Quality?

While trying to conceive, it is important to minimize processed foods and refined sugar in an effort to bolster strong blood sugar regulation and maintain a healthy preconception weight. Foods with highly saturated fat have also been known to negatively impact egg quality. Foods to avoid include butter, processed meats, cured meats, baked goods, low-fat dairy foods and sugar-sweetened drinks.

“You really want to start this process 3-6 months ahead of conception. This gives you enough time to make internal cellular changes. If you want to get pregnant in the fall, it would be best to start changing your diet at the beginning of July.”

An Anti-Inflammatory Diet Can Reduce Oxidative Stress

Oxidative stress can negatively impact egg quality, leading to decreased fertility potential. Antioxidants act as guardians that neutralize harmful free radicals and preserve the integrity of your delicate eggs. You can find antioxidants in foods such as broccoli, carrots, sweet potatoes, pumpkin, squash and apples.

However, it isn’t enough to just eat an antioxidant-rich diet; a hopeful mother-to-be should also avoid foods that are “pro-inflammatory.” These include processed meat, refined grains, refined sugar and common snack foods, such as cookies, pastries and crackers.

Is Caffeine OK When Trying To Get Pregnant?

Yes — when you’re trying to get pregnant, caffeine is ok. However, you don’t want to have so much that it causes your adrenals to be thrown off which would snowball into your hormones becoming unbalanced. 200mg of caffeine a day or less is also safe while pregnant.

Your Environment & Lifestyle Choices Play A Role, As Well

While nutrition is paramount, other lifestyle factors can also impact egg quality. Exercise, stress management and environmental toxins in fertility should all be considered when taking a holistic approach to enhancing egg quality.

“We want to avoid things that mimic hormones in our bodies like plastics and synthetics. Pollutants and pesticide exposure can impact egg quality and cause ovulation disorders. This makes smoking cessation even more crucial.”

In some cases, dietary adjustments alone may not suffice to meet all the nutritional needs for optimal egg quality. Supplements may need to be used to help enhance your nutritional intake and bridge this vital gap.

Supplements Are Helpful, But Diet Is Queen

“As a practice that specializes in fertility treatment services, we monitor key lab values and see where they are deficient and how supplements can be helpful in pregnancy planning. But remember: they are ‘supplements’ for a reason! We shouldn’t rely on supplements to get what we need; it is always best to get our nutrition from food sources.”

Supplements That Can Help Improve Fertility Include:

  • N-acetylcysteine (NAC)
  • Fish oil with EPA and DHA
  • Prenatal vitamins with choline, folic acid and iron
  • Vitamins A, B, C, and E
  • zinc and selenium
  • Curcumin
  • Green tea extract
  • Quercetin

About The Author 

Angie Scala, NP, is the fertility treatment specialist at Donaldson Plastic Surgery in Columbus, Ohio. She currently builds nutritional plans and lifestyle programs for women seeking to optimize their chances of fertility. Angie takes a comprehensive and customized approach to each patient as they embark on the fulfilling journey of parenthood.

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Creating Surgical Recovery Plans That Minimize Addiction While Maximizing Comfort

Angie Scala NP

Nurse Practitioner, Angie Scala, and Registered Nurse, Shruti Lemus, participated in the American Society of Aesthetic Plastic Surgeons conference in San Diego this year where they met plastic surgeons and aesthetic providers from across the nation. Presented by the industry’s top thought leaders, the seminars focused on opportunities for improvement in the art of plastic surgery.

At the conference, Angie attended Opioid-Free: A Better Way to Recovery presented by Dr. Lawrence Iteld. Dr. Iteld discussed alternative ways to achieve patient comfort and create an effective healing experience without the intensity of opioids. Her experience – combined with this new insight – inspired her to apply her advanced clinical knowledge to her Nurse Practitioner duties.

Downsides of Opioids During Recovery

Angie has witnessed the negative effects that opioids can cause patients to endure. Symptoms like constipation, drowsiness, nausea, and decreased activity can all be caused by opioid use and create setbacks in a surgical patient’s recovery. Medical professionals across fields are transitioning to new care plans that don’t include opioids. There are other ways to minimize pain and make a patient feel at ease without the downsides.

Plastic Surgery Recovery Without Opioids

Comfort in an opioid-free environment

After plastic surgery, pain relief through medication is often necessary. However, the strength of opioids can sometimes be excessive. Alternatives to opioids during post-op recovery include combinations of:

  • Anti-inflammatories (Ibuprofen)
  • Muscle relaxers
  • CNS relaxer (Valium)
  • Neuromodulators for nerve pain
  • Tylenol for pain relief

Like Dr. Iteld, Angie is an advocate for early activity and moving with purpose post-operatively to assist in a quicker and more pain-free recovery. She is also a firm supporter of homeopathic supplements and believes they should be incorporated into all patients’ post-op medication regimens.

Striving to Provide the Best

At Donaldson Plastic Surgery, we want everyone to be the best versions of themselves, and we apply that same principle to our entire practice. Our entire surgical team is continuously educated on the newest ideas in the surgical field. We aim to provide our patients with the best experience possible through the constant improvement of our processes.

Your Customized Recovery

We tailor post-operative regimens to each patient depending on their unique needs. We discuss the post-operative plan with patients, so they are aware of what to expect in terms of instructions and medication. If a patient requires additional pain relief during recovery, then their plan can be altered.

What We Do To Help Prevent Opioid Dependency After Surgery

Dr. Donaldson Explaining Surgery Recovery Without Narcotics

Every patient’s post-op experience is different. Our patient care team will prescribe opioids only if necessary – we want to ensure you are taken care of. However, many patients have reported not needing medication after 1-3 days due to low pain levels. This is due to how meticulous Dr. Donaldson and Dr. Sieffert are during surgery. When surgeons take their time, then recovery is quicker and more easily managed.

Our surgical teams already encourage non-opioid treatments. For example, we use TAP blocks during tummy tuck surgery; this safe, local anesthetic is injected during surgery and acts as a long-lasting pain reliever. We also recommend homeopathic supplements like Arnica Montana or Bromelain tablets to help with swelling, bruising, and pain.

You Can Get Incredible Results & Recover Comfortably

Your pain medication regimen is just one aspect of your customized experience at Donaldson Plastic Surgery. Your surgical journey begins with a personal consultation!

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