Monday, May 24, 2010

Double Vision

By Bill Benda, MD, FACEP, FAAEM

Photo by Lomo-Cam via Flickr, used under the Creative Commons License.
“Visionary.” Now there is a word we’ve all heard countless times as we meander the naturopathic path. Merriam-Webster defines the term as “one having unusual foresight and imagination.” We tend to view our visionaries as those among us who can see into the future, imagine unimaginable realities, lead us to promised lands if we are intrepid and willing enough to follow. We laud our visionaries, follow their writings, award them at our banquets.

As we should, should we hold to that particular definition. But from my boundless perspective, and limited experience, a visionary is not necessarily a prophet or clairvoyant, but rather someone who can actually discern the truth of the present moment – a point of view requiring far more courage to express than any tale of potential future pleasantries. Visionaries who can discern reality are fewer in number than the prescient variety, and those with the courage to voice their views are fewer still, given the political price that must invariably be paid, because the reality of our culture -- and of our healthcare system, and of our profession -- is not always pretty, and definitely not as pretty as our conference and clinic brochures tend to proclaim.

Now do not misinterpret these words –- the underlying beauty of the naturopathic and holistic and integrative et al. philosophies and therapies is alive and well, and more than worthy of love and support. But we in our optimistic, energy-medicine, “hugs heal” mentality are often more than hesitant to take a long, hard look at our internal dysfunctions, dysfunctions that are an essential part of our very humanity rather than an unwanted and obnoxious uncle who has overstayed his welcome. We hold onto historical injuries that are no longer relevant. Our organizations avoid dealing with whispered dissent from their membership. Industry fails to note that their journal advertisements and promises of health are not that much different than those of the conventional brethren we condemn.

And why am I writing these words on this particular blog at this particular time? Because as an AANP board member and associate editor of your journals and adjunct faculty at one of your medical colleges, and especially as a non-ND, I believe your profession is at a crossroads, an adolescent-to-adulthood moment of your evolution when it is time to let go of the past and create a new future. And this shift cannot, and can never, occur without first making a difficult and objective assessment at what is real in the present.

So the next time one of your fellow professionals or employees or students or board members stands up and points out the pachyderm in the pad, see if you can refrain from withdrawing from the inevitable discomfort and instead take a long, hard look at the actual information being presented. You may well find that you have a bona fide visionary in the room.

Thursday, May 20, 2010

Food Allergies: Fact or Fiction?

By Sara Thyr, ND

Photo by via Flickr, used under the Creative Commons License

I recently read an article in the New York Times that said that many people who have been diagnosed with food allergies don’t actually have them. They felt that perhaps only 8% of children and less than 5% of adults actually have them.

I feel that quite the opposite is true. In my practice, I see many people who have undiagnosed food allergies, and they often don’t associate their symptoms with foods. But once they avoid the reactive foods, they find myriad of symptoms that they have struggled with, for either weeks or years, disappear. Symptoms affected by food allergies are wide ranging – from making seasonal allergies worse, to ear infections, fatigue, headaches, eczema, heartburn and other digestive disorders – even high blood pressure.

Their distinction of food allergies versus food intolerance did make sense. A food allergy is actually activating the immune system. This involves antibodies. Conventional allergists often test for food allergies using the skin prick test, where a small amount of a serum with the food is injected under the skin to see if a reaction forms around the area on the skin. The antibody that is active in this type of testing is called IgE (which stands for immune globulin E). Some practitioners do a blood test, which often looks at another immune globulin called IgG (as above, immune globulin G). IgG is better at finding the undetected food allergies, as it is more prevalent in delayed hypersensitivity reactions. IgE is the mediating immune globulin for more immediate sensitivities, like those that cause inhaled allergies – like when you get itchy eyes from petting a cat, or the more serious anaphylactic reaction from eating a peanut.

A food intolerance is more common. Many people are lactose intolerant – they cannot digest the sugar in milk, and find themselves with symptoms such as upset stomach and loose stools. Reacting to sulfites in red wine is also an intolerance, rather than a food allergy.

For many people, the distinction is immaterial. They feel better if they avoid the food. So avoid the food.

One reason I like to make the distinction is that most people with food allergies are likely to also have intestinal permeability (also known as “leaky gut”). With this in mind, there are a number of therapies that can help to heal the digestive tract. Along with food allergy avoidance, healing the digestive tract can improve health, including eliminating symptoms caused by the food allergies, as well as mitigating reactions when they have any of their allergenic foods.

Whether you think you have food allergies or just an intolerance, it is wise to see a naturopathic doctor – a specialist in finding and treating the cause, as well as treating illness with the most nutritive elements nature has to offer.

Monday, May 17, 2010

Federal Policy Priorities for the Naturopathic Community: Reflections on the DC FLI

By Carl Hangee-Bauer, ND, LAc
AANP President

The Cannon House Office Building on Capitol Hill.
Photo by cliff1066TM via Flickr, used under the Creative Commons License.

Here it is, mid-May already, and it’s been a busy time at the AANP.

I’m sure you have read Karen Howard’s report on this year’s DC FLI. It was a busy four days in Washington, D.C., as over 150 people, including more than 100 naturopathic medical students, met on Capitol Hill to refine our leadership skills, meet with legislators and their staff, and create a visible presence in our nation’s capital. For a profession as small as ours, we have managed become known in the Halls of Congress. This year was my 3rd DC FLI, and I noticed that we spent much less time explaining what naturopathic medicine is and who we are and more time discussing issues important to our profession, our members and our patients.

One of our key messages involved inclusion of naturopathic doctors in various loan repayment programs created or extended under the new Patient Protection and Affordable Care Act. It’s ironic really. Both the Department of Education and the Carnegie Institute classify the ND degree as a First-Professional Degree on par with MDs and DOs. All naturopathic medical schools are accredited by the CNME which is recognized by the Department of Education and each of our schools are regionally accredited by authorities recognized by the Dept. of Ed. Naturopathic medical students are eligible for the same federal loan programs as MDs and DOs. Yet, naturopathic doctors are not named in a number of federal programs which allow us to serve in underserved communities and are excluded from participation in all federal loan repayment programs, including the Public Health Workforce, the National Health Services Corp, and the Indian Health Care Improvement Act. This is clearly unfair and is a significant barrier to NDs participating in federal programs, and in the meetings I attended, this was clearly heard by the health staff people with whom we spoke.

Our doctors and students also advocated for a consensus definition of “Integrative Health Practitioner,” a term used but left undefined in the health care reform language, and reminded legislators of our support for DSHEA, which frequently comes under attack from various legislators and agencies.

I think that at least as important as our messages and issues discussed is our presence in D.C. and the building of relationships with legislators, their staffs, and the various regulatory agencies that oversee the transformation of bill language into laws.

On another note, members of the AANP should be receiving their elections packets from the AANP very soon. This year a number of candidates have stepped up for Board positions and for the first time ever we have a competitive election for AANP President-Elect. I am impressed by the quality of our candidates and the wealth of experience, knowledge and dedication to the profession that they all bring to their candidacies. Please read over the candidates' statements and vote for your choice of our next AANP leaders. Your interest and participation are critical to the future of the AANP.

Finally, watch for materials coming soon about the AANP convention in Portland, August 11th-15th. It should be a great one as we celebrate the AANP's 25th anniversary, learn from some of the elders in our profession, and spend time with old and new friends. I hope to see all of you there.

Wednesday, May 12, 2010

On Music, Medicine, and Unconstrained Joy

By Lise Alschuler, ND

Photo by Sunny J via Flickr, used under the Creative Commons License.

I was on a business trip recently. After a full day in meetings, my colleague and I went out to dinner. As we were walking back to our car, we passed by a wine bar with some musicians in a front alcove. The muffled beat followed us as we passed by. We both simultaneously slowed down and stopped. Sure, why not? Let’s just stop in for a bit. We headed back into the wine bar, ordered a glass of delicious wine, and sat back. It has been a long time since I have sat back and enjoyed the sound of live music. The musicians were good, the seats comfortable, the wine rich. It was all good. The most inspiring aspect of the evening for me, though, was watching the musicians as they played. One fellow, a guitarist and singer, cradled his guitar like it was a newborn baby and swayed and dipped into his music as if he were the music itself. The drummer had this beatific expression on his face, further brightened with little smiles as he placed certain beats in the music just so. As I sat there watching, I realized I was witnessing complete, unimpeded, joyous immersion. These musicians met their music completely, head on and all out.

Later, as I was back in my hotel room, in the after glows of a good evening, I thought about how this display of uninhibited joy was exactly the thing that transforms a helpful encounter between doctor and patient into a truly healing one. With practiced knowledge of our medicine, faith in ourselves, openness to our patients, and a love for what we are doing, we too can make music. When all of these attributes come together into one encounter and we are in our groove, we become our own music, we are the healing. Given all of the constraints of the medical system, our schedules, the paperwork, our determination to do the right thing, it is actually quite hard to find, and stay in, this place of unconstrained joy as practitioners. And yet, these very constraints are like the constraints to the musician imposed by the scales, the frets, the rhythms – the musician utilizes these as a foundation for immersion into the music. When we practitioners allow ourselves to do the same, we too groove and sway to our own medicine. Our patients can’t help but relax and start tapping their toes and nodding their heads right in time with us. Healing is found and released right here and wafts its way into the cool night air.

Monday, May 10, 2010

AANP's DC FLI Sets New Records

By Karen Howard
AANP Executive Director

This year's annual Federal Legislative Initiative (DC FLI) topped all records.
  • Over 170 visits to Congressional offices representing 38 states and the District of Columbia.
  • 171 attendees of whom 100 were naturopathic medical students.
  • 1,500 emails were sent in one day from 'virtual' lobbyist across the country using our electronic CapWiz program to write to their Members of Congress.

A special recognition goes to the students of the University of Bridgeport for winning the "Bring a Founder to the FLI" contest and receiving the AANP's first traveling trophy for school spirit.

This year we focused on how Congress can address the critical shortage of primary care physicians by accessing naturopathic medicine. Our specific requests included inclusion in all federal loan repayment programs and defining the term "integrative health care practitioner."

The term, "integrative health care practitioner" is used throughout the health care reform law and is not defined in the statute. Our objective is to encourage Congress to ensure Americans have access to the best, most qualified providers - many, if not all, of whom are underutilized in federal programs. As you may recall, the Coalition for Patients Rights, of which the AANP is a member, represents 3.3 million such practitioners. Our proposal uses language from the original H.Con.Res 406 and H.Con.Res. 58 (introduced by Congressman Langevin) and reads as follows:

"An Integrative Health Care Practitioner, acting within the scope of that provider's license or certification under applicable State law, addresses the underlying causal factors associated with chronic disease; improves individual health and increases individual capacity to engage in activities of daily living through lifestyle change, including strategies relating to diet, exercise, smoking cessation, and stress reduction; and provides patient-centered care that:
  1. addresses personal health needs;
  2. uses a multidimensional approach to encourage patients to improve their own wellness through lifestyle changes and the use of scientifically based therapies and outcomes based treatments that facilitate the inherent ability of the human body to maintain and restore optimal health; and
  3. utilizes clearly defined standards to determine when the implementation of wellness and health promotion activities will be useful for each patient based on the diet, exercise habits, individual health history, and family health history of the patient."
What happens now? Staff is working to mine the reams of data from these very valuable visits on Capitol Hill and will work directly with several of our state contingencies of NDs to create a successful strategy for our efforts. Capitol Hill is a tad weary on the topic of "health," in general, but preliminary work is beginning on what will constitute a technical amendment bill - and the appropriations process is also available as a possible vehicle for these changes. Our relationships continue to grow and deepen on Capitol Hill and our presence is clearly having an impact.