Functional Medicine for First Responders

I remember the exact moment when thought “Man…I really need a new career”. I was 4 months pregnant and got into a knockdown, rolling-in-the-dirt kind of fight.

I was at work as a police officer. We got a call from a frantic mom that her 19-year-old son was out of control, punching walls and had just assaulted her. I was dispatched along with my favorite co-worker “Uncle Johnny”.  At 62 years old, Uncle Johnny was a police veteran, seasoned hostage negotiator and loved by everyone. He’s the kind of guy that would swap funny stories with suspects as he transported them to jail (and probably a dirty joke or two!).  

But Uncle Johnny was on his 3rd overtime shift making it a 7 day, 12 hour work week so far. He was exhausted from working too much, living on pork rinds and diet soda (his version of an Atkins Diet), getting zero exercise and no quality sleep. As for me, I was pregnant and in my second trimester.

And my department still had no idea what to do with me.

So, until they could make a decision (I was the first pregnant officer on patrol, so this was new territory), I still got up at 4:30 am to work my 12 hour shift.  But all I really wanted to do was sleep, vomit and google anything related to baby.

Adding to the fun was the constant jabbing in my lower back from my duty belt, the strong urge to go to bathroom 2 minutes after I just went and losing any feelings in my legs from sitting in a cramped car for hours. So, I was definitely not in a position for this sudden workout as we wrestled a lean 19-year-old into handcuffs.  Luckily, I only emerged with a big knot on my head as the suspect managed to slip in one head slam before Uncle Johnny ended it.

Having ‘mom’ record our incident and then later file a ‘use of force’ report just added to the unusually high amount of stress that police officers have to deal with every day.

It was right after this that I pursued my master’s degree in Nutrition. Then shortly after I received it, I retired. Not because I didn’t love Police work. But because after 20 years on the job, it took one tiny human to make me realize that being healthy and trying to stay alive was my new goal. Period.

This may seem overly melodramatic, but I assure you it’s not. It’s an example of just a regular shift on just a regular day. And the very reason I want to serve cops, firefighters and ER personnel as a Functional Nutritionist.  Or as I call them – people not guaranteed a bathroom break.

If you filled in the Functional Medicine Tree, a typical First Responder’s “Lifestyle and Environmental Factors” would look like this:

• Sleep and relaxation – shift work, long hours and court dates = broken/no sleep. Working 18+ hours is not uncommon.
• Exercise/Movement – sitting is 95% of the job. Exercise is limited due to long and overtime shifts.
• Nutrition/Hydration – fast food is a staple with 7-11 or gas stations acting as the refrigerator of many meals. Hydration comes in the form of coffee and energy drinks.
• Stress/Resilience – Chronic/acute stress is ongoing due to the nature of the job. Resilience is continually weakened because most First Responders are too proud to ask for help or show signs of weakness.
• Relationships/Networks – Divorce is common [8,9]
• Trauma – witness to suffering and investigating violent crimes including those against children and the elderly is part of the job. This is a high contributor to police suicide as these scenes replay in your mind with no optional off button.
• Microorganisms/Environmental Pollutants – chronically exposed to chemicals, disease, toxins, decaying bodies, drugs, EMF signals, feces, etc. is also part of the job. There are certain smells that TV cop shows just can’t capture to make it real enough for me.

Many of these routines, “all in a day’s work” exposures have been directly linked to cancer and cardiovascular disease in Police Officers as well [4,5.]

First Responders are also a very unique group because their job is essentially to protect, serve and assist others. But when they need help themselves, they rarely reach out for it. From my personal experience, this is primarily due to the cultural tone within this group that view any weakness as a serious character flaw. So, it should be no surprise that it’s also a career characterized with high suicide rates1 and chronic disease [3.]

I can name several recent co-workers who fall into this including my fellow female detective who recently suffered a massive stroke at age 48 [6], a traffic officer diagnosed with stage 4 brain cancer at 63, a young Firefighter with stage 4 cancer7 and even old Uncle Johnny who retired after suffering a CVD event. Even more tragic is that Police suicides continually surpass on-duty deaths [1, 2.]

So how can we help this group?

It will take some creativity to support First Responders with a Functional Nutrition and Lifestyle protocol because their situations are a bit unique.  

Take sleep for example.

When I was deployed in the Marine Corps, my schedule looked something like this:

• 12 hours working as a radio operator (sitting) then 24 hours off. So, my bedtime would change by 12 hours every single day.

When I worked night shift as a police officer, my schedule may have looked like this:

• Up at 4pm. Start work at 6pm – 6am. Go to sleep by 7am and up again by 9:30 am to testify in court. Sleep for 2 hours then back to work at 6pm.

When I worked as a police detective, my schedule may have looked like this:

• Up at 4:30 am. Start work at 6am – 4pm. Go home and get called out to a scene at 11pm. Work until initial investigation is over and go back to work. It was not unusual to work 36 hours straight.

As a result of an unpredictable sleep schedule and high adrenaline atmosphere, there are also many who rely on sleep aids like Ambien.

Here are some suggestions that worked for me and have also helped others that operate within these unique restrictions.

SLEEP: Cultivating healthy sleep hygiene is especially critical due to irregular and long work schedule.

• Removing caffeine consumption (Starbucks is our lifeline) for the second half of their shift.
• No workouts including pre-workout supplements at the end of their shift.
• Taking time to decompress. This means making a focused effort to shift from caretaker role to self-care – without the use of alcohol, pharmaceuticals, stimulants (TV, video games) or inflammatory “comfort” foods.
• No screen time 1 hour before bed.
• Listening to a calming audio book in bed to help interrupt any disturbing or stressful thoughts preventing them from sleeping.

STRESS: We are trained to be in a state called “condition yellow” for the duration of our shift. This is to create an area of awareness for Officer safety reasons. Yes, this means the sympathetic response is constantly turned on by choice.

• Lean on tactical/mindful breathing enroute to calls or when they’re in a safe zone.
• Encourage them to reach out to peer support groups. Cultivate that “It’s cool to talk about it.”
• Find ways to fill their minds with joyful images/experiences during their days off.

MOVEMENT: After a long flight, do you feel all achy and stiff? Most First Responders are sitting all day long, mostly in a cramped vehicle.

• Volunteering for foot or bike patrol.
• Getting out of the patrol car every 60 minutes and walk, even if it’s just to stretch for 5 minutes.
• Doing more community policing, which requires walking.
• Taking advantage of any on-duty workout time. If there is none, working with the guild/union to have this negotiated into their contract.

DIET: It’s not uncommon to have a 12-hour shift bleed into a 18 hour shift. And there are limited healthy choices on night shift. Steering them towards a lower carb diet will automatically reduce the amount of 7-11 Slurpee’s, energy drinks and $5 Teriyaki specials.

• Always pack extra food. Especially ones that can sit in a patrol bag for a few days like nut butter, beef jerky, BulletProof bars and water.
• Grab a meal at a 24-hour grocery store. Some healthy choices are canned salmon, fresh fruit and vegetables, rotisserie chicken, clean deli meats and grass-fed cheese.
• Scan the menu for words like “grilled” that indicate less processed protein choices.  Skip the sauces and higher carb items like rice or bread that will lead to a predictable crash right when the big call comes in. Replace it with stir-fried, grilled or roasted veggies, salads or soups.
• Most restaurants also offer salads. Pass on the croutons and any dried fruit. Load up on protein, veggies and olive oil instead.

SOCIAL: Divorce is common [8,9] I suspect it’s from long work hours and the feeling that their significant other just doesn’t understand what they’re going through so that connection becomes lost.

• There is no “us” vs “them” when it comes to family. Take that first uncomfortable step to cultivate a connection with loved ones. They’re probably waiting for you to do this.
• Get involved in a peer support group or local church. This allows you to share your experiences in a safe environment.
• Stop cruising social media. It’s an unrealistic snapshot of how citizens view this line of work. They actually support and appreciate you more than you think.
• Remember that all we have is the present moment. So, don’t put off spending time with those you love. You have vacation time. Use it.

My last big investigation was a shaken-baby case. My little slice of closure came with a conviction. Yet the photos, videos and interviews that I spent weeks meticulously reviewing still infects my thoughts. But I know my dedication to nutrition, quality sleep, strong relationships and regular movement during my 20-year career has spared me from a fate many of my brothers and sisters in blue, red and green have succumb to.

And this is also why I want to highlight and spearhead this grossly under-addressed crisis hiding within this sadly underserved circle.

It’s my hope that Functional Medicine practitioners will agree that it’s time to take care of the caretakers so that they can continue to stay strong on the front lines.