Friday, August 28, 2009

AANP Convention: Friends, Medicine, and Dancing

By Sara Thyr, ND

Where else can you go and be surrounded by people who love you completely, learn cutting edge information in the most exciting healing field in the world, eat healthy food and dance your hiney off in the same week? Not to mention stunning views of Mt. Rainier?

This year's AANP convention in Tacoma was too good to be true. I didn't get enough sleep, and the only exercise I got was the dancing. But those small injustices aside, I truly had a great time.

I learned some things that I will bring back to my practice that will help my patients - always my favorite thing about convention. Many docs wave off atrial fibrillation - Dr. Paul Saunders did a great talk showing us all of the therapies we can use that work. The vaccine question plagues many of us who see children - Dr. Matt Baral gave an insightful presentation that cleared much of the muck around that issue.

I got some good information about some new products - another fabulous benefit.
And best of all, I really got filled up by the love of my community of exquisite healers.

There were too many great ones to list here. Well, you know...you were there!
What? You weren't? What's the matter with you?

Friday, August 21, 2009

Why I Love the AANP Convention

By Tabatha Parker, ND

The reason I LOVE AANP conferences is because you can stay up all night having amazing discussions with NDs and then every morning you all gather together to keep learning and growing. I am constantly amazed at the work our profession is doing, at the intention with which we move thru the world and at the passion we all carry with us as we walk upon the earth. I truly thank each of you for inspiring me to be the best ND I can be. And of course, there is nothing like late night conversations with Russell Marz to put you in a whole new frame of mind!!!!

Tabatha Parker, ND
AANP Board Member
Natural Doctors International
Executive Director, Medical Director NDI Nicaragua

Thursday, August 20, 2009

Hello From Tacoma!

By Sara Thyr, ND

Day one of "Physician, Heal Thy Planet" started out with James Stark of the
Regenerative Design Institute talking about renewing our connection to
nature. As physicians who talk about the healing power of nature, we fall
prey to losing our own personal connection to it like everyone else on the
planet. Asking us to think about a moment in nature from our childhood and
then sharing it with those next to us was an insightful exercise. He also
showed some great footage of Joanna Macy from the documentary "The Great
Turning" where she talked about the benefit of uncertainty. That is where we
are most courageous and innovative.

I didn't get to see too many talks today, but did get to connect with many
old friends and classmates. In those priceless moments of hugs and quick
catch-ups in the hallway reminds me of the joy of being in this amazing
community.

I loved hearing about the escharotic treatment for cervical dysplasia. We
have an amazingly powerful non-surgical treatment in our repertoire and many
NDs are forgetting about it, or have not been properly trained to perform
it. Drs Windstar and Jones are to be commended for reminding us about it's
effectiveness and clarity on how we can all do this in our offices.

Matt Baral did a wonderful job with lots of research and insights in his
vaccine update. I think I will have to get the recordings to hear it all
again.

Not to mention the many fabulous presenters who I didn't not get to venture
into their presentations today. There is so much fabulous information being
presented.

My assessment - it's great, overwhelming, and I'm ready to rest up for
tomorrow.

Monday, August 17, 2009

Julie, Julia, and Naturopathic Medicine

by Marcia Prenguber, ND, FABNO

So I have just returned home from seeing Julie & Julia – fantastic movie! As soon as I arrived home, I immediately went in search of my copy of Julia Child’s Mastering the Art of French Cooking. The sense of enthusiasm and the excitement of the projects these two women undertook is some significant bit of inspiration. And what does that have to do with a blog on naturopathic medicine? The pounding heart excitement about the world of cooking and the pleasure of food in the movie is the same as that which I feel about our medicine. No, I have not lost my mind – I am just recognizing my joy as it is portrayed in the movie. The chance to explain our medicine to a patient who is unfamiliar with the principles and tools of naturopathic medicine, the opportunity to educate a group of health care librarians who are na├»ve about the medicine, or the questions that come from the group of medical doctors listening to a presentation on the integrative approach to treating cachexia makes me feel like the Julia Child played by Meryl Streep. Yes, I can get that excited and I am sure many of you do as well. I know that this is passion – but really – that is such a tame label compared to what I saw in this movie! Julia makes her passion sooo much fun! Maybe it’s her voice.

My husband and I recently had the delightful opportunity to visit a gentleman who is also a patient of mine, and his wife, at their home. We live in a rural area that is home to a large group of Amish, known for their choice to live without electricity, to use horse and buggy for transportation, and for their magnificent vegetable and flower gardens. As we visited with this Amish couple and enjoyed the strawberry pie they made that afternoon, their children and grandchildren began to gather in their home. Word was out that we were there to visit and it was an opportunity to chat. We talked about organic gardening, about energy production, and about various approaches to health - conventional, naturopathic, and Amish healing. We all had lots of questions, ideas to share, and great pie. How much better can it get? So my enthusiasm, like Julia’s, is organic, local, and renewable.

Tuesday, August 11, 2009

Letting Nature Heal

By Jacob Schor, ND, FABNO

Reading Lise’s blog just now generated a response that isn’t suitable for print that questioned what I could write that might be appropriate to follow her treatise on universal love and chronic disease.

I’ve been thinking about much more mundane matters; how cold and rainy it’s been in Denver in contrast to Portland which apparently has had a bit of a warm spell. Those sorts of things. OK, let’s try writing this AANP thing:

I was up later than I wanted to be last night following an interesting trail through PubMed. There is growing awareness that serotonin may affect bones for the worse, increasing bone loss and increasing risk of osteoporosis and fractures. The first hints appeared a decade back and have gradually accumulated over the years. At this point it’s pretty much a sure thing. Taking SSRIs in order to increase serotonin levels increases bone loss.

This new knowledge shows up as our suppliers are once again selling l-tryptophan and promoting its use to increase serotonin levels.

OK, so we should be a bit more cautious with blindly raising serotonin levels in our patients. But the bigger issue is what were we thinking in doing this in the first place? After all, we are we not supposed to be naturopaths and is not our goal supposed to be to stimulate the vital force or the vis medicatrix naturae or something along that line. What does feeding our patients with isolated chemicals, in this case l-tryptophan or 5HTP, have to do with stimulating the vis?

What we were thinking of course is that Prozac works by raising serotonin levels and sometimes makes people happier. If Prozac and l-tryptophan do kind of the same thing, well the later is more natural and seems like an ‘alternative medicine.’ The thing is that we are not ‘alternative medicine doctors.’ We did not go to ‘alternative medicine school.’ Perhaps we need to remind ourselves this once in awhile.

The more we understand about the human body, the less sure I am that I really understand anything. Serotonin is made in both the brain and the gut. L-tryptophan is converted into niacin or serotonin and can then be made into melatonin. The gut makes far more melatonin than the brain does. Serotonin and melatonin play at least several roles in the intestine, helping regulate intestinal motility, healing injury and moderating inflammation.

So though exceptionally easy to reach for a bottle of l-tryptophan or of melatonin I still wonder, is it the right thing to do? Might we get a deeper and more profound effect by taking a more ‘naturopathic’ approach? I often find myself imagining how particular patients might respond to a month of old time nature cure. If they were to spend day after day on forced hikes through the Austrian Alps, early to bed and early to rise, bathing in cold water, the whole deal, how many of their complaints might resolve without further intervention? Would this push start a more robust circadian cycle and by strengthening melatonin fluctuations not have some positive influence on serotonin production as well?

Neither we, nor our patients, often have the luxury of really testing out these imagined months away from job and family so we are left with the simple question. How best to restore normal function with the least intervention? In the end, patients don’t come to us for philosophy, they come to us for help. If a bit of an amino acid nudges a patient’s chemistry so that she sleeps better, it’s not the end of the world. Yet, few of us are satisfied that this is a cure, but it is an improvement.

Although my concerns over serotonin and bone mass are new, the questions it raises in my mind are old. Not just for our profession, but through the history of medicine. How much does the physician intervene? How much do we step back and let nature heal? Do we know enough to help nature heal? Are our theories correct or will our misinformed attempts backfire and interfere with nature’s own efforts? Or to ask the sacrilegious question, ‘Does nature really know what to do in the first place?’

As a profession we can be almost cultish in our belief in nature as an all-knowing omnipotent healer. Let me quote a respected medical writer on nature’s healing properties:
“If the organism alone is left to the task, by its own forces and without external aid, …. we then witness nothing but painful, often dangerous efforts of nature to save the individual at whatever cost, which often terminate in extinction of the earthly existence, in death….What the vital force does in these so-called crises and how it does it remains a mystery to us like all the internal operations of the organic vital economy. One thing, however, is certain: that in all these efforts more or less of the affected parts are sacrificed and destroyed in order to save the rest.... In short, the entire operation of the self-aiding power of the organism when attacked by disease displays to the observer nothing but suffering, nothing that he could or ought to imitate if he wishes to cure disease in a truly artistic manner…..

“……the unreasoning life-preserving power when left to itself in disease, which, entirely dependent as it is upon the organic laws of the body, is only capable of acting in conformity with these laws, and is not guided by reason and reflection—the crude nature, which cannot, like an intelligent surgeon, bring together the gaping lips of a wound and by their union effect a cure; which knows not how to straighten and adjust the broken ends of a bone lying far apart, ……which cannot put a ligature on a wounded artery, but in its energy causes the patient to bleed to death; which does not understand how to replace a dislocated shoulder……which in order to remove a foreign body from the cornea, destroys the entire eye by suppuration; which with all its efforts, can only liberate a strangulated hernia by gangrene of the bowel and death; and which by the metaschematisms it produces in dynamic diseases, often renders them worse than they were originally.”

-Samuel Hahnemann
Our image of this Vis that we so eagerly wish to embrace and employ to heal all patients of all things is perhaps oversimplified. Great doctors for centuries have professed and debated the nature of this ‘power’ and how best to aid and abet it.

Our image of the Vis is a conglomeration of the ideas put forth by these great practitioners, often very conflicting ideas, that in our innocence we think are all one and the same. The proponents of the Vis Medicatrix Naturae would view our interpretation of their ideas as a hodgepodge of opposing thoughts and our attempts to utilize the healing power of nature as to be inconsistent. We are justified to criticize some of these practitioners for using violent treatments on their patients justifying their actions because they were mimicking the healing power of the body when it triggers vomiting, diarrhea, ulceration and hemorrhage.

So who am I to question whether l-tryptophan is good or bad. The only thing I can say today is that current information suggests the need to balance Tryptophan use against risk of osteoporosis.

Tuesday, August 4, 2009

Fame!

By Bill Benda, MD

This article is reprinted with permission from the peer-reviewed journal Integrative Medicine: A Clinician’s Journal (www.imjournal.com), vol 7 issue 1, pp 64. Copyright 2008, InnoVision Health Media (www.innovisionhm.com).

“Some struggle and strive and make a vast difference on our planet, only to die in obscurity. Others are born on third base and go through life thinking they’ve hit a triple.”


I received a call several months ago from a good friend of mine, a naturopathic physician with years of clinical experience, one book, and several prior political offices hanging like Christmas ornaments from her resume. She was distraught and angry, fortunately not with me in this particular instance. It seems she had picked up a copy of a popular “news” journal at the supermarket, drawn to the cover story touting the effects of dietary changes on fertility, her specific area of expertise. I’ve read the article myself; it’s basically a glossy six-page excerpt from a new book by two Harvard medical doctors.

So why was this accomplished ND up in arms over a mainstream public magazine espousing an arena reflecting her own hard work and professional expertise? Simply this: After years of fighting the allopathic tide, taking hits for suggesting a non-pharmaceutical approach for an issue of great emotional impact, and helping numerous women achieve their reproductive ambitions, a couple of envoys from an ivory tower of medicine were about to garner the reverence, influence, and income that accompany the royalty and royalties bestowed through public acclaim.

This was not the first time such a perceived offense had confronted her. And not the first time it has confronted me. Indeed, my address book is replete with souls who have, through great effort and persistence, subtly affected the medical paradigm that is slowly loosening its grasp on our healthcare system. Yet perhaps only a dozen or so of their names would be recognized by either the integrative professional or integrated layperson. Even for those who have achieved national acclaim, fame has often been as much the result of cultural timing as sheer talent—as talent is a not uncommon attribute in our field.

I can imagine the absolute frustration of seeing one’s own sermons, so carefully prepared and nurtured, splashed through the pages of Time or Newsweek. “This is mine!” thunders the ego, not without reason. “I gave up income, security, and comfort to walk this path! If anyone’s face belongs on that cover, it’s mine!” I know such words well; I’ve had this internal dialogue with myself on more than one occasion over the years. Indeed, a desire for personal recognition was one of the original motivations that launched my expedition from the shores of conventional medical. But slowly, and not without significant discomfort, I’ve begun to let go of such desires.

Partially this has been due to the natural aging process, as I’m beginning to accept that I will never be president or cure cancer. But mostly it’s because I am beginning to understand what the sages have always known—that it ain’t about me, babe, as much as I hate this particular deduction. It’s about what I do with my time on earth, whom I touch, how I love. Because for all of our plans and dreams, the fact is that the recompense for living is as unpredictable as life itself. Some struggle and strive and make a vast difference on our planet, only to die in obscurity. Others are born on third base and go through life thinking they’ve hit a triple. This is nowhere more evident than in our field of integrative medicine, where a moment on Oprah trumps a decade in the laboratory, and an Ivy League degree confers a moniker of brilliance, no matter the actual grade point average.

So to comfort my dear acquaintance, and my own fragile ego, I would say this: Life appears to be not a mirror but a window. It will never disclose to us who might be the fairest of the fair or reflect back to us the true meaning of the long and convoluted thread that unravels as a result of our efforts. It will simply reveal to us where we must travel next, who still remains to be healed, what still requires our continued attention.

Yes, I still long for the kudos and cash that might come from seeing my face on a popular website or in the conference brochure between the pictures of the palm trees and the girl in the yoga pose. But reality continues to trip me up each time I meander down that particular path. I no sooner start than I find myself once more trudging towards the hospital or back at the computer keyboard trying to make sense of this irrational realm we call healing and healthcare. But every once in a while, I am awarded with a thank you card from a patient I have since forgotten or the thoughtful note spawned by my last editorial. And I remember that, for me, fame has been a drug without a disease, leading only towards addiction and abuse—and that, whenever I have tasted it, I have come out the worse for the experience. And somehow, in this thought, I find a sense of peace.