Holiday Cheer in Trying Times

By Lise Alschuler, ND, FABNO
AANP Past-President (2008-2009)

Photo by CCAC North Library via Flickr, used
under the Creative Commons License.

‘Tis the season to be jolly! … A whole season to be full of joy, conviviality, glee and laughter.  I reflect on that as I think about two patients. One is an extremely vivacious, fast-talking, go-and-get-‘em young woman diagnosed with ovarian cancer. She concluded integrative therapy early this Fall. She felt great and her motivation to continue to live healthfully was strong. She even took her mile-a-minute self into a Tai Chi class and is learning to love the peaceful gracefulness of this exercise. And then, a follow-up scan just before Thanksgiving found several new tumors in her liver.  Just after Thanksgiving, she began a new round of chemotherapy. She understands that her that her prognosis is guarded and yet, her jolliness has not diminished in the least. She ends every email with a salutation of love and gratitude. She wishes her providers good health and happy Holidays. Her sense of exuberance in daily living continues to reverberate in her being.

President's Message: A Final Farewell

By Carl Hangee-Bauer, ND, LAc

AANP President

Winter is upon us as I write this, my last blog as AANP President. It is a time for drawing inward, reflection and preparation for growth as well as new things to come as the light begins to return and Spring is right around the corner. We see this season reflected in our microcosm of the AANP, with our Executive Director of the past nine years having moved on, Board members departing (Thank you so much, Trevor Holly Cates and Corey Resnick!), Helen Healy finishing her term as HoD Speaker, and other changes in AANP staff. It is truly a time of great change and with that change comes challenges and opportunities.

AANP's renewal is already taking shape, like an early Spring thaw. Terri Deerr has stepped into the role of Chief Operating Officer (COO) and will manage the association during the interim period as we seek our next ED. Michael Cronin takes the reins of AANP President on January 1st and brings vigor, passion and new ideas for moving the AANP and profession forward. Bruce Milliman is stepping up as the next HoD Speaker, and the Board welcomes new member Michelle Simon. 

As I like to say, "Change is the order of the Universe." I believe these changes are timely and I'm optimistic about the growth and future of the AANP. We must embrace change if we are to adapt and grow.

The Circle Game

By Bill Benda, MD, FACEP, FAAEM
2011 Naturopathic Champion Award Winner

Photo by Helen White via Flickr, used under the Creative Commons License.

So. It’s time to find a topic for the next edition of the Physicians Who Listen blog. I know because a week or so ago I received the gracefully worded request from Matthew Santoro, the Communications and Media Associate of the AANP, gently reminding me that Friday is the deadline.

President's Message: Thanking and Honoring Karen Howard

By Carl Hangee-Bauer, ND, LAc
AANP President

Exiting Executive Director Karen Howard poses with AANP President Carl Hangee-Bauer, ND, LAc (left),
and Bill Benda, MD, FACEP, FAAEM (right), at the 2010 AANP Convention.

It is a time of great change for the AANP and perhaps the most significant is that Karen Howard, our Executive Director for the past nine years, will be moving on at the end of November. Karen has left a huge mark on the AANP and the naturopathic profession and she will be missed. As I pondered what fitting words to say to mark this occasion, I turned to other AANP Past-Presidents to ask them what they would like for us to remember about Karen as we thank her and honor her work. So, without further ado...

Red Leaves in Fall

By Jacob Schor, ND, FABNO

Photo by Mike Gifford via Flickr, used under the Creative Commons License.

We traveled to the east coast recently. Ostensibly we were going to a wedding and for Parents Weekend the following weekend at our daughter’s college, with the days between spent at the family cabin in Maine. In truth, we were going to see the leaves.

The leaves of deciduous trees change colors in autumn before they fall off the trees. Obviously this process gives name to the season. Less obviously, the Greek term for this leaf falling phenomenon is the etymologic base for the modern term ‘apoptosis,’ which describes the process of cellular suicide, an honorable and desirable decision when initiated in cancer cells. Why trees exhibit such a wide range of colors has been one of those unanswered questions for both the questioning mind and modern biologists.

The Run Hits Capitol Hill

By Dennis Godby, ND, MA

The Run: Moving Natural Medicine Forward

The Run: Moving Natural Medicine Forward has just left Washington, D.C., seven days from the first end of The Run in New York City 11-11-11 (Veteran's Day), and just 15 days from the end in Bridgeport, CT (11/17/11)!

We left Capitol Hill at 5 pm on Wednesday after a full day of meetings and photo opportunities with ten Members of Congress (Sen. Rob Portman (R-OH), Rep. Chaka Fattah (D-PA), Rep. Gary Ackerman (D-NY), Rep. Mike Fitzpatrick (R-PA), Sen. Barbara Boxer (D-CA), Rep. Edolphus Towns (D-NY), Rep. Larry Bucshon, MD (R-IN), Rep. Lacy Clay (D-MO), Sen. Mike Lee (R-UT), Rep. Tim Johnson (R-IL), and their staffs, exhausted, but extremely grateful for a wonderful, action-packed day! The staff and Members of Congress were extremely enthusiastic about The Run and our message!

Data Points

By Shiva Barton, ND, LAc
2011 AANP Physician

A few things happened to me recently that made me very happy to be a naturopathic doctor, and made me wonder about what's up with the rest of medicine. I will present my conclusion first in case you want to cut to the chase:

CONCLUSION
It is really so evident that by easily employing even the simplest tools of nature and naturopathic medicine you can have a tremendous positive impact on a person's health, either in conjunction with or instead of conventional medicine, depending on the situation. The influences of pharmaceutical marketing and the social glorification of technology have sent our culture looking for health-care saviors in the completely opposite direction to that which will "cure the cure."

The rest of the story, with a common theme....

Pre-Conception Testing: A Naturopathic Perspective

By Sara Thyr, ND

Photo by lunar caustic via Flickr, used under the Creative Commons License.

When couples decide to get pregnant, most think that they just need to take good care of the baby in utero. Some only worry about nutrition and toxins after the child is born. New research about epigenetics tells us that what you bring into the pregnancy can be even more important for the long-term health of your baby. Diseases like diabetes and heart disease have been linked to toxins to which babies are exposed in the womb. Asthma and allergies are inflammatory disorders with which many children suffer, and the health of the mom during pregnancy can have a great bearing on them.

President's Message: Changes at the AANP and in the Health Industry Landscape

By Carl Hangee-Bauer, ND, LAc
AANP President

It’s a busy time at the AANP (as always) and has been particularly busy for me with the leadership changes on the horizon. Many wheels are turning and progress is being made. Let me bring you up to date on a few key events and activities.

Renewal

By Lise Alschuler, ND, FABNO
AANP Past-President (2008-2009)

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

October is the month of my birthday. As such, I have long experienced October as a unique flow of emotions and reflections. As my birthday approaches, I find myself awash in the incoming tide of anticipation and the receding tide of closure. As my current year runs itself out, a peaceful sense of finality spreads its way into my consciousness. I reflect on my prior year with feelings of gratitude and deep appreciation for all of my experiences. I find myself letting go of unresolved issues and troublesome questions. It is as if I am at a door looking back into a room that holds all the experiences of my past year. I see the way the room has been arranged; I note the piles and the empty spots; I see the shafts of sunlight streaming in here and there; I notice dust in a few places. I see all this with quiet, peaceful eyes, and then, I gently close the door behind me.

You Like Me, You Really Like Me

By Bill Benda, MD, FACEP, FAAEM
2011 Naturopathic Champion Award Winner

Dr. Benda accepts the Naturopathic Champion Award at the 2011 AANP Convention Gala.

I received an award at August’s AANP annual convention at the Biltmore, a brand new one entitled the Champion Award, which from this time onward will be given to a non-naturopathic individual recognized for his or her contributions to the field. It was a bit of a bittersweet moment, for a number of reasons, which, in my semi-shocked and semi-intoxicated state, I revealed to the gathered audience of several hundred.

President's Message: Convention Notes and the Search for a New Executive Director

By Carl Hangee-Bauer, ND, LAc
AANP President

AANP President Carl Hangee-Bauer, ND, LAc, and President-Elect Michael Cronin, ND, with their
wives Michele Hangee-Bauer and Kyle Cronin, ND, respectively.

It’s been two months since my last President’s blog and there has been a lot of water under the bridge since.

The 26th AANP Convention at the Arizona Biltmore has come and gone and was a success by all measures. I had a great number of people come up to me and tell me that this was the best conference they could recall, from the quality of the sessions to the results of the elections and annual awards. Everyone seemed to enjoy him- or herself at our favorite convention venue.

There are many congratulations in order. Dr. Michelle Simon is our newly-elected Board member, with Drs. Kasra Pournadeali and Dr. Michael Reece re-elected to second Board terms. Dr. Joe Pizzorno will succeed Dr. Corey Resnick as our next Treasurer, and Dr. Bruce Milliman was elected the next Speaker of the House of Delegates. And, as you all know, Dr. Michael Cronin will be succeeding me as your next AANP President in January.

Thank you to all who ran for Board or House leadership positions, congratulations to all who were elected, and thank you to all who have served and will be moving on to more challenges and opportunities, particularly Board member Dr. Trevor Holly Cates and House Speaker Dr. Helen Healy.

Our 2011 awardees were met with great appreciation and applause by attendees at the annual awards banquet. Dr. Shiva Barton is our 2011 Physician of the Year, Dr. Louise Edwards received the Vis Award, Dr. Bill Benda received the new Champion Award, and Dr. David Field received the President’s Award. Emerson Ecologics was named AANP Corporation of the Year and Dr. Ryan Bradley and Joshua Goldenberg, ND candidate, received research accolades. These awardees have all demonstrated great dedication to the naturopathic profession and have accomplished great things, some over a lifetime of service. They are examples to us all and we thank them and congratulate them from the depths of our hearts.

Just a few days before the start of the convention, Karen Howard called to inform me that after nine years as AANP Executive Director, she has decided to retire and move on. The announcement was later made to the Board, House of Delegates and the convention attendees at our annual meeting. Karen’s decision has reverberated through our community and set a tone at the convention that was reflective of her many accomplishments, her impact on the naturopathic profession, and the mixed emotions in the community with her moving on.

Karen joined the AANP during a time of great change and has been an instrumental force in our move to Washington, D.C., and our greatly increased federal presence. She has overseen many developments in our organization that we take for granted today, including development of practice development resources, the state alliance, our website, strategic coalitions with groups aligned to our purposes, and of course our annual DC FLI.

Her fiscal prowess has been exceptional. When she started as Executive Director, the AANP had a $276,000 deficit. As of the end of 2011, we have a positive balance of $402,000. We owe much of our prosperity and fiscal good health to her steady hand.

Karen has offered to stay on as Executive Director while we begin our search for her successor, and there will be plenty more to say before she completes her work with the AANP. I plan to devote one of my next blogs to Karen and the impact she has had on the AANP and the naturopathic profession, so stay tuned!

With Karen’s announcement, I immediately activated our succession planning process and appointed an Executive Director Transition Team (EDTT) consisting of Dr. Michael Cronin, Dr. Joe Pizzorno, Dr. Keri Marshall, Dr. Lise Alschuler, Dr. Harry Swope, David Matteson, and me. The EDTT has been meeting weekly to establish a rational process for succession. Our first steps have been to assess strategically the current state of the association, the needs and goals of the organization over the next five years, and the assets and profile of an ideal executive to fit our needs now and in the near-term future. We anticipate completing our assessment and posting a job description in October, and hope to begin the interview process soon afterwards.

We will do our best to keep in good communication with you as we move through this process, and appreciate the community feedback we have already received. This is some of the most important work we will do as an association over the next three to six months and the choices we make will affect the progress and goals of the AANP over the next five to ten years. The better the job we do now, the better we will meet our common goals. If you have any ideas or feedback that you think would help us be most successful, please send it to me at Carl@SFnatmed.com.

We plan to keep you up-to-date with these monthly blogs and in other venues as needed or appropriate.

Tempus Fugit

By Jacob Schor, ND, FABNO

Last June, Louise Edwards, ND, (who had occupied our guest room the night before) helped me load a grandmother clock into the back of my car and haul it home. We’d been for a walk in the park with the dog and stopped at an estate sale on the way home. Not only did we leave with the grandmother clock (a smaller version of a grandfather clock), but also a new nightstand for her bedroom. Well, actually Rena and my guestroom, but since Louise is such a frequent guest, we sometimes refer to it as Louise’s room.

The clock has the Latin words "Tempus Fugit" on the faceplate. This seems to be a common thing on clocks. It translates, of course, to mean, “time flies.”

Given that the clock chimes on the quarter hour, it certainly enforces that thought. Rena and I have gotten into the habit of saying "tempus fugit" out loud each time the clock starts to chime away. It adds a bit of urgency to what already felt like busy days.

Thus when we attended the AANP convention this past month in Arizona, it’s those two words that started echoing in the back of my mind, something of a little mantra. Over the last few years at each of our conventions, time has been set aside to remember colleagues who are no longer with us or who, at the present, are in such need of divine intervention, that I suppose we figure that some sort of communal prayers won’t hurt.

This year is was Konrad we remembered and Molly we prayed for.

Time flies. None of us are getting younger as the saying goes. We are fast approaching the time when losing colleagues will not be a rarity but for will seem all too commonplace.

On our website Rena and I have a photo posted from the 1934 convention of the American Naturopathic Association:

A group photo from the 1934 convention of the American Naturopathic Association at the Albany Hotel in Denver, CO.

At the time the picture was taken (probably using Kodak black-and-white film), the American Naturopathic Association was celebrating its 38th annual congress.

Time flies. From the look of these delegates, as smartly dressed as they were, the majority, if not all of them, were long passed before the first AANP convention.

Time flies. Our profession experienced a resurgence over the last few decades and that first wave of new doctors are not getting any younger. It will only be so much longer that we have to listen to stories about going to school in Kansas. At some point Kansas will be a secondhand memory.

Time flies. That clock keeps ticking and chiming away the minutes as I write. I’d swear it was going faster and faster. My beloved wife has developed a habit of reminding me that our life together may be more than half over. It’s a sure way to cut the foundation out of any disagreement we might be having. We have those talks about what we want to do with the rest of our lives. Where do we want to live? Those of you at a certain age surely know what I’m talking about.

Time flies and we start making lists of things that we still want to do. We joke about our new purchases and that they should last the rest of our lives. There is that book I keep meaning to write. Is it time to set aside the time? What was it supposed to be about anyway?

Time flies and we keep going to work and seeing patients who it seems each year come in sicker and in greater despair than I recall from years’ past. Or perhaps their despair is more contagious? They certainly seem sicker. How ludicrous that any of our schooling was devoted to otitis media when many days all the patients we see have cancer. Metastatic cancer. Our patient population has aged along with us.

Time flies and I find myself thanking a deity for the minor events in my life, for sustaining me long enough to once again taste a fall apple, for a taste of this year’s honey, for another week of work, and for patients that feel better.

Time flies and I’m reminded by an email from the AANP office that I have a blog due later this week. That clock makes it hard to get lost in distraction. How can one drift into oblivion reading a good mystery when with every tick of the clock another second has been lost.

Time flies and I’m not halfway through with today’s to do list. I’ve got the dishwasher fixed, the Natural Medicine Journal review draft finished and sent in, and almost enough of this AANP blog post written to call it quits. There’s still email to check, the dog to walk, supper to cook and a complex patient to be ready for in the morning. Time flies and what a pleasant ride it is…

PoY Boy, Two Thousand Eleven

By Shiva Barton, ND, LAc
2011 AANP Physician of the Year

As you probably know, I had the distinct honor of being awarded the AANP Physician of the Year Award for 2011. I cannot begin to tell you how deeply honored and grateful I am to have received this award. It continues to be very moving to me to be nominated by my peers and to be deemed worthy of this award.

I don't really remember much of my acceptance “speech”—I hope it was inspirational, or at the least, coherent. In any event, I am sincerely grateful and moved, and appreciate the vote of confidence. Naturopathic medicine is such a wonderful healing art. I think we take for granted that everyday, besides helping the garden variety illnesses, we are helping people that do not have any other options to get well. At least, that is much of what I see in my practice. We help people who, for whatever reason, are medical outcasts. And we can help many of them recover their health and lead happier, healthier and more productive lives.

It is an honor to be able to share naturopathic medicine with my patients, to teach about it at the conferences, and to inspire preceptees who come to visit my practice. So I am very grateful for being recognized as contributing to the improvement of this wonderful and challenging profession and will truly cherish this award for the rest of my life.

OK, enough with the sappy stuff...

I'm reminded of the famous quote: “There is no such thing as a free lunch.” Well, a few days after I returned home from the conference I get an email from the great Matthew Santoro of the AANP. (I say “great” when referring to Matthew because he is doing such a great job sending us the AANP Clips. Always informative, and frequently clinically relevant. Please send Matthew a big email thank you!) So Matthew emails me. Here is the subject line of that email: 

Congratulations on the PoY Award and a Request!

Well, it took me a few seconds to realize that PoY was not the Hawaiian delicacy, but AANP shorthand for Physician of the Year. As for the request, I figured that he wanted an autographed picture of me to hang in his office. Well, that would be a problem... The only picture that I have of myself in a suit - not including the snapshots of me in a tuxedo—but that's another story...—was taken about six years ago.

When I came home from this conference and told Elena, our office manager, that I had won this tremendous honor she told me in no uncertain terms that I had to publicize it. Now, if you know me—and I do remember saying this in my acceptance speech—I am the kind of person that likes to sit in the back of the room, be quiet and not draw any attention to myself… OK, well maybe crack a few jokes while I'm back there. Hence, I never make the effort to do the publicity stuff that I should be doing, such as keeping a current picture to provide to autograph hounds and to send out with press releases. This is one of the ways the PoY has already changed my life. I have to take this publicity thing seriously. (Note: neither publicity nor serious is part of my primary genetic code.)

So in order to fulfill my office manager's order and my supposition of what Matthew wanted, I had to get a professional picture taken. I arranged to have a photo session at the local portrait photographer's studio for last Tuesday. I think the idea of me potentially damaging my DNA by getting an up-to-date professional portrait was too upsetting for the forces of nature. How do I know this? Well, Hurricane Irene blew through our area and knocked out the power to the photographer's studio—one of the few structures in our community that was affected by the power outage. As of this writing, she still has no power, so the laws of nature so far are preserved. (Preserving the laws of nature, of course, is very important to us as naturopathic physicians.) Such are the obstacles encountered on the path to naturopathic greatness, or maybe even a spot on Oprah. Needing a picture, I had to take one of myself. I think I'll keep my day job...

Well, it turns out that Matthew wasn't asking me for an autographed picture after all (I still think he's great in spite of this). This is what he wanted:

We request each year that the PoY become a regular writer for our blog, Physicians Who Listen, and I’d love to have you on board! Your first due date would be the Friday, September 2, by 5 PM EDT. You can write on a topic of your choice or, at your request, we can suggest a topic for you...

This is where the “No such thing as a free lunch” comes in... Win an award, write a column. I think Matthew didn't realize that my favorite author is Dave Barry. Not sure how inspiring that will be. I remember one time riding shotgun while my brother-in-law was driving down the highway, reading a Dave Barry column about dressing up as Batman for his young daughter's birthday party. I remember we were laughing so hard and I couldn't see because the tears were running down my eyes. I remember hoping my brother-in-law could see and thinking that I was glad I wasn't driving or I would be dead. Had I died, I never would have lived long enough to get this award and write for this blog. For that I am eternally grateful, or will be grateful for as long as I live, which will not be for eternity, guaranteed... But the point of naturopathic medicine is not to help people live forever. It is to help them to be as healthy and happy as they can be, and when it is time to go, to pass peacefully, and maybe tell a few jokes on the way out.

So, Matthew, here is my first column. As you can see, I picked a topic of my choice. How do you like the picture I took?

Reflections: Naturopathic Medicine, Convention and Volunteerism

By Sara Thyr, ND

The Arizona Biltmore. Photo by AANP President Carl Hangee-Bauer, ND, LAc.

Upon returning this week from the AANP convention at the Biltmore in Arizona, I have been very busy. Which is fantastic. I’m very grateful. But it has not allowed much time for reflection on all that has happened, one of the gifts that being away from our usual circumstances often affords us. But being at the convention barely allows time for a few deep breaths, much less assimilating what we are learning and assessing our place in our national association. So I will take a few moments here to offer some of my musings regarding our time together, a family of healing professionals, basking in the sun and the desert heat.

First of all, while naturopathic medicine is still not more than a blip on the national landscape of health care, I was reminded yet again at what an amazing roll we might have in really, truly repairing not only the health-care system in America, but the health of all Americans. As we move into a new era of leadership in our community, I hope that this opportunity is realized.

Which brings me to thoughts about the resignation of our executive director for the past nine years, Karen Howard. I have a love-hate relationship with Karen and possibly always have. Let’s not call it love-hate. Let’s call it love-irritated relationship. We have very different styles of communication. I’m soft, squishy, and easy to tears—and dream of acquiring tactful disagreement skills. Karen is strong and outspoken and has no problem sharing her opinion, even if that may mean (what feels like) steamrolling over quieter voices. That said, I believe with all my heart that she has been the right person for our association for most of the last decade.

Karen has brought incredible awareness of our profession to our nation's capital—a stark change from the beginning of this decade. She has created networks within our own profession to assist more states in licensing naturopathic physicians, to help states with standing licenses to work together in improving scope of practice and marketability of NDs within those states, and she has taught so many of us how to come to our legislators with our information and expertise and ask for what we want. The DC FLI was an incredible undertaking and has blossomed with incredible success over the years. Most legislative health aids and legislators today know what a naturopathic physician is. This was not the case before Karen Howard took over the roll as full-time steward of our profession ten years ago.

Within the framework of the State Association Leadership Team (SALT), Karen taught us about strong associations and strategic planning. Many of us in our states' leadership roles brought this knowledge back to our states to assist local leadership in becoming more organized and stronger—not to mention becoming more proactive than reactive, learning to quit operating via putting out fires and start planning for the future.

When Karen took over as executive director, our association was fractured and deeply in debt. She thrives on picking up pieces in great disarray and building something that is stronger than it was before. And that she did. While I felt her resignation like a blow to the gut, once I recovered and began to breath again, I realized that she has equipped us with the ability to move forward and continue to achieve our goals as an association. And as one physician who has worked with her for many years, I feel that I will continue to be able to achieve my own goals with much of the knowledge and experience that she has helped me acquire. I am deeply grateful for her touch in my life.

While I was working as president of the New Hampshire Association of Naturopathic Doctors, I was inspired at a SALT conference to bring in a consultant to work with our association on strategic planning. It was a challenging process, but one where we moved forward as a group and all learned a lot. One thing that I have always held from those days of meetings was about volunteerism: our consultant impressed upon me that we should never separate our volunteers from their passion.

It takes a great deal of time and commitment to volunteer for any work—and perhaps most especially for this profession—because there is so much to be done and so few people to share in the tasks, which at times seem larger than life. I have worked on putting together speakers for the AANP Convention for the past four years—task which I think Karen inherently knew was my passion, and could rely upon me to spend many hours trying to perfect the process. It is bittersweet to let go of chairing that committee—made easier only by leaving it in such capable hands as those of Dr. Jacob Schor.

Karen Howard had an innate ability to recognize people’s passions – and help them find a way to fit service to our organization into their busy lives. I am not certain if it is testament to my lack of backbone or her great persuasive skills that I could not say no to her. Maybe I’ll try to hide for a while from our new ED! :’)

Hiring Rebecca Takemoto and her staff at Sync-Opate to handle our convention and other meetings such as the SALT and FLI was another insightful move on Karen’s part. Rebecca makes the convention run incredibly smoothly, and is perfectly cut out for a job where she is juggling 40 things at once and smiling calmly as she deals with the latest crisis. And let’s not forget the food. She makes sure that the chef’s anywhere we go provide fresh, green, allergy-sensitive foods—and as seen at the Biltmore—that taste wonderful.

When I look at our profession as a whole, from topics as diverse as the national legislative process to the process of trying to figure out what topics at a conference will be most interesting, I find myself perplexed. We are both so alike and yet so incredibly different. As Dr. Matthew Baral so eloquently said in his closing keynote address, there is no me, only us. There is no mine, only ours.

I wish many blessings for Karen as she finds a new place to share her incredible strengths.

A Little Zest with That Naturopathy?

By Lise Alschuler, ND, FABNO
AANP Past-President (2008-2009)

Photo by Larry Neuberger via Flickr, used under the Creative Commons License.

My sister, partner and I were in a local florist shop this past weekend to shop for some flower arrangements. It was the end of the day and we entered this tiny, one-room floral shop that had pieces of plants strewn on the floor, pictures of arrangements on the walls, and a few flowers poking out of a vase here and there. The owner explained that she had just finished several bouquets for a wedding. She excitedly brought out her iPhone, “Here, you have to see this. I am so excited about this arrangement. It was all plants!” She brought up a picture of a truly beautiful arrangement of succulents and grasses. We oo'd and ah'd and then, getting right down to business, began to issue forth our desires.

All I can say is that the next 30 minutes were pure delight. I never knew that buying flowers could be so exciting. She listened to every word, asking multiple-choice clarifying questions in a way that suddenly made us feel like flower experts. She exclaimed with outright glee at each mention of a particular: type of flower (“Oh, I LOVE thistle!”), shape (“Mixing textures is gorgeous!”), color (“Deep reds are so earthy, so royal. I love it.”). She was masterful. Somehow she helped us to create a gorgeous bouquet that we thought of all by ourselves but, truth be told, could never have come up with on our own.

We left all commenting on how wonderful she was, how passionate she was, and how much she loved her work. It showed, too. She had a book of her work and her arrangements were stunningly beautiful. We were all a little giddy, actually, and I realized that by her unadulterated and unbridled enthusiasm, she had transformed us into delighted beings, entranced with the simple and wondrous beauty of plants.

While one might argue that she has a fabulous medium to work with, there is no denying the fact that she is definitely in her groove. And the results are incredible both in her arrangements and in her impact on her customers. I can’t help but imagine the impact that being that wildly and ardently in love with one’s craft (in my case, naturopathic medicine) would have on my patients. I love naturopathic medicine and I embrace it to its core, but I have to admit that it is the rare moment when that zest for naturopathy flows out of me, unfiltered, to my patients. There are a million good reasons why this is just not proper, useful, conducive or even appropriate… and yet I do think that I, along with several of many patients, could, every now and then, use a good dose of juicy, succulent and untempered gusto for naturopathic medicine.

Perhaps letting the medicine out of its constraints every once and while could transform naturopathic medicine into a naturopathic superhero – capable of transforming dis-ease into exuberant health in an instant.

Domestic Violence and Patient Safety: A Personal Story

By Christine Girard, ND
2010 AANP Physician of the Year

Those of you who know me, know I am a fairly private individual. Through this blog, I have tried to expand my comfort zone by sharing with you what I hope to be funny moments in my personal life. This blog post may be my most personal–ever.

On the morning of July 2nd, William and I were in Phoenix International Airport preparing to fly to Eugene, Oregon. My god-daughter, Mikaela, is a very musically talented 16-year-old, who for the last two years has been accepted in the Oregon Bach Festival’s Stangeland Family Youth Choral Academy where she has the privilege to study with and be conducted by the top Bach scholars in the country.

While in line for airport security, I realized I had a voicemail from my Mom–unusual for an early Saturday morning. Standing in line I listened to her voice mail. She was crying, “I don’t want to do this on voice mail, but I have to. Jill is dead. They think Kenny shot her. Dale is a wreck. Jack and Judy are driving me to Dale’s. I can’t drive. I don’t know what we’re doing. We need to fly to Jacksonville. Call me when you get this.” William looked at me quizzically as I was listening to the voicemail. I motioned him to lean in and I whispered Mom’s message to him. Needless to say, he raised his eyebrows.

Once through security, I paced at an empty gate while talking with Mom. She was in the car with neighbors Jack and Judy, who were driving her to Dale’s house. Mom recounted the shocked phone call from Dale. Very little was known about Jill’s death.

Dale and Jill’s Dad, Warren, married my Mom, Carol, when Dale and I were seven and Jill was three and a half. Mom and Warren had Mark, our half-brother, five years later. We grew up in the '70s version of the blended family. Jill met Kenny in Connecticut and when the Navy transferred him to Georgia she was heartbroken. She decided to follow him to Georgia and married him soon after. She was 23 years old.

What we know about Jill’s death is that she was shot to death in her home in the very early morning hours of July 2, ten days before her 42nd birthday. Her husband, Kenny, is currently held without bond on charges of First Degree Murder.

In the 18 years Jill and Kenny were married, friends and family have no evidence of Domestic Violence (DV). I say that with some confidence. As Dale has said, “Even though I’m her big brother, it seems like she took care of me more than I took care of her.” Jill did just that: she took care of friends and family who were ill or needed a temporary assist. Both Warren and Dale have lived with Jill and Kenny.

Kenny’s brother and Mom have also lived with them. Family would mention arguments (as Dale says, “like any couple”), but no one could speak to any abuse–emotional, economic, psychological, sexual or physical–in their marriage. As far as the detective, assistant state’s attorney and victim advocate can see, Jill’s death doesn’t fit the normal pattern of DV.

As a family, we struggle with the many unanswered questions. As a physician, I am reminded of how important it is to assess a patient’s safety in his or her own home. DV affects approximately 28% of marriages and results in over 16,000 deaths annually. It sickens me that Jill’s is counted among them.

I encourage you to add safety questions not only to your new patient intake, but also to your routine history-taking. Click here to learn about DV screening tools for your practice. A recent article revealed that women want their physicians to ask. Please, don’t be afraid to ask your patients about DV.

If there is one thing I can say about Jill, it’s that she loved and cared for many people in her life, none more so than Kenny. He was a central part of her life for 18 years. She would want us, in the midst of our shock and anger, to remember that. She would insist that life goes on and that in life joy must be found.

When you see me at the Convention, please say hello, give me a hug, and/or tell me your newest joke. No sad puppy eyes, please. And give Drs. Olehausen and Clark an extra hug. They, along with Carolyn, my amazing assistant, ran the show (brilliantly, I might add) while I have been out on an extended bereavement leave. My thanks also to my SCNM family: Dr. Mittman, the SCNM Executive Team,  and Faculty and Staff for their thoughts, prayers and support. They gave me the freedom of time and space to begin, with my family, the lengthy journey of processing, grieving, administering, and seeking closure of Jill’s death. May her memory be eternal.

Resources for more information:

• MedlinePlus: Domestic Violence
• American Association of Family Physicians
• National Coalition Against Domestic Violence
• Center for the Prevention of Sexual and Domestic Violence
• Bureau of Justice Statistics
• Centers for Disease Control and Prevention

Reversing Type 2 Diabetes Using Natural Therapies

By Susan DeLaney, ND, RN

Natural remedies can help reduce or even eliminate the need for insulin in Type 2 diabetes patients.
Photo by .:[ Melissa ]:. via Flickr, used under the Creative Commons License.

Conventional medicine recommends exercise, a healthy diet and losing weight to prevent the development of Type 2 diabetes. But these same measures, along with a few supportive supplements, can also reverse the disease process. After many years of eating highly refined foods and excess sugars, one's nutrients stores are depleted. My real focus in reversing Type 2 diabetes becomes one of restoring health through nutrient rich foods. It is unfortunate that the conventional practice of medicine operates from the perspective of disease management and not the restoration of one’s health. With treatments that only manage the disease symptoms, the progression of the disease continues even with excellent control of blood sugars. Blindness, peripheral neuropathy, and heart and kidney disease are the long term consequences of a disease only held in check by medications.

In one patient's case, just eliminating all processed foods for one week, such as cereal, bread, pasta, crackers, pizza, cake, cookies--anything that made from a refined grain or sugar--reduced the need for insulin shots by 50%! He was able to maintain the reduction in his insulin doses by restricting these foods and eating high-nutrient foods such as eggs, meats and healthy fats such as butter, cheese, nuts and avocado. Beans became a daily staple of his diet, along with greens and any fruit and vegetable he desired. Daily exercise of his choice for 30 minutes each day was also initiated to improve his glucose levels.

Typically diabetics have low vitamin D levels, which is really just “the canary in the mine” indicating that they are low in all of the fat soluble vitamins such as A, D, E and K. The fat soluble vitamins (not really vitamins but pro-hormones) act together to help regulate many aspects of the immune and endocrine system. Using cod liver oil (high in vitamins A and D) along with High Vitamin Butter Oil (high in vitamin K2), these food-based supplements begin to restore these deficiencies. The diets of traditional people eating their native diets contain 10 times more fat soluble vitamins than the western diets of today. Restoring healthy fats to our diets, as well as eliminating trans fats and all refined oils that help deplete our fat vitamin stores, will help nourish the body and reduce the need for diabetic medication.

Along with the introduction of healthy fats, I also use a fermented powdered food from fruits and vegetables taken twice a day as a supplemental shake to increase the nutrient levels, speeding up the healing process. After six weeks, my patient was able to drop his insulin by 75% with a weight loss of 8 pounds. He continues to take metformin for his elevated blood sugar levels, but after 3 months is off all insulin. Along with the reduction in his insulin levels, his Hemoglobin A1C levels have dropped from 8.8 to 7.0.

Continuing his nourishing diet and supporting his system with food based supplements should totally eliminate his need for medication in the future. Restoring health prevents the development of chronic disease and reduces the need for expensive medication. It is possible to reverse, not just manage, Type 2 diabetes using natural therapies.

In Search of the Holy Grail

By Bill Benda, MD, FACEP, FAAEM

Photo by speckyfish2000 via Flickr, used under the Creative Commons License.

I sat on an NIH panel a couple of weeks ago in Washington, D.C. Our mandate: to determine which of a few dozen grant applications deserved, through purity of methodology and virtue of intent, to be awarded funding by a commercial enterprise whose name I cannot reveal.

In fact, I wish I could tell about you the subject of the grants, or the people who sat on the panel with me, or the amount of monies given away, or how we determined who got the cash. But the NIH is very, very adamant that nothing ever, ever leaks to the outside world on what transpired those two days. Non-disclosure forms are signed, warnings are given, and papers and discs are shredded after the proceedings are completed. I imagine there is a sophisticated surveillance system set up in Bethesda, MD, to watch our every step, and should I inadvertently write the wrong words in this blog, an alarm sounds on the east coast: NIH Central Alert! Reviewer violation! Activate liquidation team! And within the hour an ominous black Prius would pull up in front of my house and bespectacled men in trench coats would emerge.

But I digress from the topic of this article. My time on the panel did serve to reinforce one particular belief I have harbored over the past couple of decades as I have explored the world of scientific investigation – that research, for all of its academic and cultural value, is not health care’s Holy Grail. It is not representative of any irrefutable fact, it is not the courier of absolute truth, and it certainly is nothing close to purity of thought and action.

Now before those of you who spend most of your waking hours in academia start sharpening your ninja swords, let me state firmly that research itself is indeed the best tool we have at our disposal to differentiate reality from fiction in the clinical arena. But it is a fragile tool, and prone to breakage and misuse. And I do hold a touch of credibility on this particular topic - I have conducted and published two randomized control trials (one funded by NCCAM), and have been providing peer review to six medical journals over the past decade or so. So I can state with some authority one thing that I have never seen echoed in any journal, except perhaps on the editorial page or in a letter to the editor, and that is: All research is flawed, and likely quite badly flawed.

Lets take a look at the process of publishing a study, from the first inkling of an idea to the final inking on the journal page. Someone, somewhere, comes up with a hypothesis. After much thinking and mulling, the hypothesis transmogrifies into a research plan–usually in conjunction with other co-investigators–then into a methodology, complete with inclusion and exclusion criteria, plans for statistical analysis, recruitment, carrying out the study, collation of data, actual statistical analysis, final conclusions, writing of the paper, peer review by a journal, revisions as requested by said journal (and perhaps repetition of this step several times), publication of the article, reading and attempted understanding by the subscriber and, finally perhaps, incorporation into clinical use.

There are countless steps where bias and error can creep into the final findings, and this doesn’t take into account influence by industry if the piece happens to be on a pharmaceutical or other medical appliance. And speaking of pharmaceuticals (and supplements), the study usually recruits a narrow demographic of males between this age and that age with this clinical condition but not complicated by that clinical condition (exclusion criteria!) and then treats at a specified dose for a set period of time. And if the positive findings are somewhat higher than the placebo effect, that pharmaceutical (or supplement) is marketed to men and women from 18 to 88 with all sorts of confounding conditions and with each very diverse patient getting pretty much the same dosage. This is part of the reason why, say, hormone replacement therapy protected against heart disease last month, but increases heart attacks this month, while protecting against breast cancer last year, but thought to stimulate breast cancer next year, and on, and on.

OK, I’m going to back up once more and restate a very important point: Research is the best tool we have at our disposal to differentiate reality from fiction in the clinical arena! But it’s simply not as perfect as we, and our media, purport. As I tell my students, no research study, no matter how well done, is the truth; it is simply another finger pointing in the general direction of the truth.

So the next time that your organization wants to put research at the top of its priority list, consider… Wait a minute...

I need to go. A black Prius just pulled up in front of my house.

Where Do We Live?

By Jacob Schor, ND, FABNO

Photo by Liralen Li via Flickr, used under the Creative Commons License.

There’s a Hebrew expression that roughly translates as "Where do you live?" It’s not meant to ask the location of a person’s residence. Instead it expresses shock, dismay, or disbelief in the ideas held by the person being addressed. By implication, "Do you live on Mars?"

During the winter, I go skiing with my friend Jim every Wednesday. We have done this for almost two decades, from opening day in November to closing day in May. Given the many shared months of our lives spent shivering together, I guess it was fitting that when Jim came back from a business trip to Dublin last winter, he brought me a gift: a handmade wool sweater.

This beautiful sweater came with a brochure affixed to it with one of those plastic fasteners, which needs to be snipped off lest you leave a hole in the garment. The brochure informed me that because the sweater was made of Merino wool, it would be comfortable year round, winter, spring, summer and fall. It is a beautiful sweater and nice to wear outdoors with my vest when the temperature is in the twenties. It’s even wearable indoors when I’m writing, the heat is off and the temperature is below sixty. I’ve tried unsuccessfully to wear it a few times this spring. I joke about wearing it in the summer. We live in Colorado. It’s too hot here to even touch wool during the spring and summer. Though it makes for a good joke, "Oh, the temperature has dropped to 85. Shall I wear my sweater?"

I mention this sweater because I use it as an analogy. That information on that sweater tag teaches us two things. The first is obvious: you can’t believe everything you read. That certainly applies to a good many ‘miracle cancer cures’ my patients read about on the Internet and then expect me to believe in. I tell them about the sweater.

The second sweater lesson is less obvious. The statement that the sweater is wearable year round isn’t false. It’s probably true if you live in Ireland. The truth is relative. In the case of my sweater, to where you live.

My ruminations on the relativity of truth are triggered by Nathan Seppa’s article in last week’s Science News titled "The Sunshine Vitamin."ⁱ

Nathan Seppa and before him Janet Raloff have in their earlier Science News articles closely followed and reported on the growing vitamin D research over the last ten years. This article on the surface purports to cover both sides of the debate triggered by last year’s Institute of Medicine’s report on vitamin D.

Last November, an Institute of Medicine (IoM) panel of scientists announced new vitamin D recommendations. They recommended daily intakes of 200 to 600 IUs per day. For most of us who follow the growing data on vitamin D, and routinely prescribe doses ten times this high, these suggestions seemed absurd.

Seppa points out the argument on which most vitamin D proponents fall back: that "… these amounts still fall short of prehistoric people’s intakes by a Stone Age mile." Living outdoors with little clothing, these people manufactured thousands of international units, or IU, every day, perhaps getting three to five times as much as most people get now.

Seppa then goes on and writes a comprehensive review of the benefits associated with vitamin D. He reviews the many research studies that form the basis of our thinking that vitamin D can produce anti-viral, anti-cancer, anti-allergy (including asthma, allergies etc), anti-autoimmune (including DM, and especially MS), anti-neurodegnerative (Parkinson’s disease, Alzheimer’s disease), anti-hypertensive and anti-cardiovascular disease effects.

Seppa contrasts the IoM’s recommendations with those published this month by the Endocrine Society in the Journal of Clinical Endocrinology & Metabolism.ⁱⁱ "The society, the world’s oldest and largest group devoted to hormone research, called for vitamin D intake levels two to three times higher than the IOM’s recommendations."

The question in my mind isn’t which of these opinions to follow. For naturopathic physicians, this is a no brainer. The majority of us will follow the guidelines and thinking of the Endocrine Society over those of the IoM. The question is why varying groups of intelligent and well-meaning scholars see the world so differently.

I think our views are tainted by the day-to-day needs of clinical practice and the demands it places on us to make pragmatic decisions based on often incomplete data, while those of the IoM panel are made in the academic luxury of being able to stall until more data is available.

Seppa quotes Patsy Brannon, a molecular nutritionist at Cornell University and a member of the IoM panel, who expressed the need for more randomized to settle the question:

"We looked extensively at those areas," Brannon says. In non-bone research, she says, "We found very limited randomized controlled trials, and evidence for cause and effect was not present."

At this point, there is slim if any indication that vitamin D supplementation will be hurtful and ample suggestion that it will provide vast benefits. But that’s our point of view.

This brings to mind another recent article, this one in last Sunday’s New York Times by Siddartha Mukherjee, the author of 2010 book The Emperor of All Maladies: A Biography of Cancer, which won the Pulitzer Prize for General Nonfiction. In his Times article, he reviews the evidence behind the current fear that cell phones will cause brain cancer and compares it with the evidence that links formaldehyde exposure to leukemia and smoking with lung cancer.

Mukherjee points out that the link between formaldehyde and cancer was known in the 1970s. It wasn’t until recently that the National Toxicology Program actually announced the connection. He blames industry lobbyists, particularly plywood manufacturers, for delaying this official stance.

Mukherjee reminds us that "The human trials that established that tobacco smoke is a carcinogen were initially performed in the mid-1950s (some even earlier). The tobacco industry mounted an aggressive campaign to discredit the data, and continued marketing tobacco to the public. The landmark Surgeon General’s Report on smoking and cancer was released in 1964. And it took yet another decade of innovative strategies, including powerful anti-tobacco advertisements and tort cases against tobacco companies, to alter the trajectory of smoking behavior in America."ⁱⁱⁱ

It can take a long time for knowledge to move from research publications to changes in public awareness and behavior. Let’s not even attempt to explain the recent trend toward increased smoking in young people in certain parts of the country.

Seppa sums up the arguments against the IoM’s desire for better evidence of vitamin D effect, and their desire for more randomized controlled trials by quoting Cedric Garland of the University of California, San Diego:

Besides, randomized controlled trials have never been the sole arbiter of medical thinking or policy, Garland says: "If they were, we would all still be smoking cigarettes and no one would be wearing seat belts."

We may never have randomized controlled trials on smoking because at this point it would be unethical to assign people to a ‘smoking arm’ of a trial. The weight of the evidence in support of vitamin D may soon bring us to a similar situation. How can we ethically tell people in a control group to not take vitamin D?

When it comes to wearing Merino wool sweaters in the summer, I don’t live in Ireland. What’s true in Ireland is not true in Denver.

We have to accept that the members of the IoM committee do not live in the same world we do. When it comes to encouraging higher intake of vitamin D, I want to think that we live in the real world, where our desire to improve patient health comes first in our list of priorities.

---

ⁱNathan Seppa. The power of D: Sunshine vitamin’s potential health benefits stir up, split scientists. Science News / July 16th, 2011; Vol.180 #2 http://www.sciencenews.org/view/feature/id/332009/title/The_power_of_D_


ⁱⁱHolick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM. Evaluation, treatment, and prevention of vitamin d deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2011 Jul;96(7):1911-30. PMID: 21646368


ⁱⁱⁱMukherjee S. Times Patrolling Cancer’s Borderlines. New York Times. July 12, 2011. http://www.nytimes.com/2011/07/17/opinion/sunday/17Mukherjee.html

President's Message: Remembering Dr. Konrad Kail and "The Run" Takes Off

By Carl Hangee-Bauer, ND, LAc
AANP President

Dr. Konrad Kail

In just the past several days, two events have occurred that have a profound impact on the naturopathic community.

I’m sad to report that the first is the passing of Dr. Konrad Kail on the morning of July 18th. Dr. Kail was diagnosed with malignant brain cancer several years ago and, with the dedicated support of his wife Petie, used both conventional and naturopathic treatments to fight this terrible disease. Unfortunately he finally succumbed and died peacefully in Petie’s arms in their home in the Phoenix area.

Dr. Kail was a force in our profession and a true leader who has left a mark that will endure for many years. He was a founder of SCNM and later chaired SCNM's Board of Trustees. He also chaired the Arizona State Board of Examiners and was the first naturopathic physician to sit on an NIH Advisory Council. Dr. Kail served a term as President of the AANP, which I remember well with his “One Person, One Project” campaign. Whenever there was a call for help to move some project forward, Dr. Kail was in the front of the line.

Konrad was a personal mentor for me, and he and Petie gave their time and wisdom generously. After California passed the Naturopathic Practice Act and I was making plans with my colleagues to expand our practice and transform it into a larger naturopathic medical clinic, they spent time with us sharing their experiences running a naturopathic practice, giving encouragement and advice on what worked for them, and helping us see the pitfalls and challenges that would lie ahead. They wanted to see this profession expand and see other doctors meet with success, and actively worked toward making that happen. I am sure we were not the only ones to benefit from Konrad and Petie's wisdom and experience.

Konrad was also an avid golfer, and I had the good fortune to play golf with him on multiple occasions when I visited Phoenix. On the golf course he was much the same as in his life as a naturopathic physician: bigger than life, bold, and a teacher. I will miss those outings.

Dr. Kail touched many of us in our journey in naturopathic medicine as a teacher, mentor, leader, scientist, researcher and entrepreneur. He will live on in our hearts and our history, and his wife Petie will always be a member of our naturopathic family. We will sorely miss his presence.

There’s one final note on Konrad that many of you may not know. In 1983, shortly after completing his studies at NCNM, he and a small group of NDs took a bicycle trip across the United States on their “Wheeling and Healing Tour” to introduce the public to naturopathic medicine. Through his radio and in-person interviews and connections with people along the way, many Americans got their first exposure to naturopathic medicine.

Similarly, on Sunday morning, July 17th, Dr. Dennis Godby, his sons Isaiah and Jeremiah, and his nephew Jonas Ely began their cross-country run from San Francisco, California, to raise awareness of naturopathic medicine and the true choices people have to empower themselves, improve their health, and prevent chronic disease such as diabetes and obesity. I had the pleasure and privilege to sponsor and plan the opening event as we sent Dennis and his entourage on its way, and along with David Schleich from NCNM, headed to Marin County to meet them at the end of the first day of their run.

The Run: Moving Natural Medicine Forward

As most of you know, they will pass through many small towns and big cities, from the streets of San Francisco to Main Street USA, carrying this message to thousands, perhaps millions of people along the way before ending in Bridgeport, Connecticut, in mid-November.

This is a win-win situation for our profession. Not only will their run raise awareness about naturopathic medicine and the choices it offers, it is also an opportunity for naturopathic physicians both along the route and in general to raise public awareness about their individual practices.

I urge you all to get involved and support The Run. If you are along the route, plan and sponsor a local event celebrating the runners as they pass through your town. Donate to their effort; Dr. Godby is sacrificing for this in many ways and needs our support. I donated a penny a mile for each of the 4 runners, a mere $130. If we all did this it would go a long way to meeting the goals for this historic run.

We had a lot of fun on Sunday and look forward to following Dr. Godby on his journey, and wish him all the best.

It’s the Little Things…

By Christine Girard, ND
2010 AANP Physician of the Year

A typical Airstream. Photo by Jacob Davies via Flickr, used under the Creative Commons License.

It’s the little things…

William had a rough day yesterday. No, a seriously rough day. As he put it in one of his texts, “Bad karma morning. Way overheated. Had to walk away from it.”

As I understand it, it all started after he dropped me off at work. There was a huge crash on the 202 that left traffic at a standstill, so bad that the cops re-routed traffic through downtown Tempe. Getting home took three times longer than usual. Now William is a not-so-patient guy with a plan. He had things to do at home. Let me re-phrase that, he had a list of things to do at home. So, this put him “behind.”

As he arrived home, he noticed that Lotus (now nicknamed Killer Kitty for her hunting prowess) did not greet him outside as she usually does. This made William suspicious. As he entered the house he found a trail of feathers leading from the kitty door through the living room and down the hall into the guest bedroom. In the guest bedroom he found said Killer Kitty playing with one partially denuded pigeon, which happened to be alive as William discovered upon wresting it from Lotus’s mouth. The pigeon, much relieved and a bit disoriented flew across the hall into the shutters above Sage’s favorite sunspot where Sage was napping. Awakened by the flapping of wings, Sage leapt up and promptly began chasing the pigeon as it flew down the hall into the living room. By this time, Lotus had caught up and William was in hot pursuit. The pigeon perched and pooped on top of the entertainment center as the cats sat staring, plotting their plan of kill. William stood plotting his plan to get the pigeon outside where, in his humble opinion, the bird belonged. The bird, having its own opinion, flew into the laundry room and hid behind the dryer. I’m not sure which it was, feline or human, but someone flushed it from hiding and it flew onto the bookshelves where William finally was able to cover it with a towel and take it outside – after he locked the kitty door. His next text: “Kittys on house arrest.”

William, not to be taken off plan, began to get things set up so he could move the 31’ Airstream travel trailer from its current parking spot to another that would offer him more opportunity for shade as he worked on it and offer more space to park the truck. As he later explained, it took him “hours” to hitch the Airstream in the 112° heat of Phoenix in a truck that has no (zero, zilch, nada) air conditioning (yeah, really). Once hitched, William needed to pull the Airstream forward and back it up, negotiating around the orange tree into the new, highly sought-after parking spot. His next text, “Tried moving the A/S and creased the passenger front quarter. I am so pissed.” I phoned William to check in. He was not in a good place. There were many words I cannot put in print. He expressed his desire to use C4 (explosives for those of you unfamiliar) to blow up the Airstream.

Later William picked me up from work and during the tense ride to do a couple of errands (he was still not in a good place), I learned that not only did he dent the Airstream; he backed the truck into the accursed orange tree and shattered his passenger side taillight. Errands complete and driving home, William stated that he needed my help to get the Airstream parked because after his drama of the afternoon, he left the @&!^%#$ Airstream on the lawn. He needed to get this done that evening so he could let it go. I asked if he needed to do this before or after dinner. He said, “Before.” As I said, he’s a guy on a mission.

Home, in the now 108° heat, I found myself in the precarious position of offering a severely pissed off and hypoglycemic man directions not only on how to drive, but also on how to back up a 31’ trailer. Do you see my precarious position?

The first order of business was to extract the truck and Airstream from the accursed orange tree. Seriously, it only happened because God is good and the tree, fearful for its life, sucked its branches in a couple of inches to let the Airstream pass unscathed. Then onto the business of backing the Airstream into the glorified parking spot, which would allow for the very high priced commodity of shade in Phoenix. Around the orange tree (no longer accursed as it had cooperated with the extraction process) and next to the carport (which has a very pointy front corner of the roof that seemed to leap out in an effort to strike the Airstream – maybe it was a mirage from the desert heat), across the driveway, over the lawn, into the flower bed. Back and forth. Back and forth. Back and forth… Yeah, it took awhile. "A while" here is measured by the number of trips the Teach for America guys took to the dump as a result of moving in across the street: seven.

I went inside and began dinner while William cleaned up outside. By the time he came in and showered, dinner and a gigantic vodka tonic were waiting for him. We ate and he began to come around to himself. He apologized for being tense and harrumph-aly. He talked about how nothing seemed to go right during the day and how pissed he was about denting the Airstream. And how he was going to miss me because I was to fly out the next morning to attend a conference. We talked about my day and just hung out. A little later, while he watched a movie, I went into the kitchen and began to make brownies, his favorite. Done, so crispy on the outside and fudgey-gooey on the inside, I brought him a plate of brownies and gave him a hug. “Wow! “ He said, “Thanks. Chocolate is good!”

“Yup, you’re welcome Sweetie. It’s all about the little things. I love you.” He smiled and hugged me, “Love you too, Sweetheart. Thank you.”

Upcoming Convention – There is Hope!

By Sara Thyr, ND

I have the very time-consuming and honorable task of co-chairing the Convention committee and reviewing the talks before the conference to be sure that they are free of commercial bias. It can be a daunting task. We receive many really enticing abstracts, and have to work together to find the ones that will be the most interesting and educational to the most brilliant naturopathic doctors in the country.

As I look over the schedule and presentations for this upcoming Convention, I am filled with incredible pride, and–more mushy–a great sense of hope! There is a deep need for our medicine in the world and now is the right time.

I know first hand the incredible effort and time it takes to prepare a lecture for the AANP Convention. It is a daunting task to present to your peers. And what we will be able to listen to this year comes from some amazing and inspiring leaders in the field, and some doctors who have put together very well-researched and inspiring lectures.

What makes me so hopeful is knowing that we will come away with information about how a simple plant may help us deal with infections that are resistant to antibiotics. We will learn how epigenetics and preconception health affects health throughout our lives…the true heart of preventative medicine. We will have a chance to learn from some of the most practiced homeopaths in our profession – how to make homeopathic prescriptions as a naturopathic doctor that will increase our effectiveness with patients. We have a chance to hear about the importance of creativity in healing and actually learn how to help our patients implement this for the benefit of their lives. We can learn from someone who does more nutrition research in a week than most of us do all year about all of the myths and important research in the literature that most of us don’t find the time to look at. We can learn how genetically modified foods are dangerous and the interesting mechanism used to grow these foods that makes them so harmful (along with the shocking information about how our government, influenced by industry, continues to ignore the health risks involved).

Do you know how medicinal botanicals can help with neurodegenerative diseases? You will if you make it for the concurrent sessions on Wednesday. And if you are torn, as I am, about listening to that talk or learning about how to treat cancer patients if you are not a cancer specialist, have no fear. The AANP is making sure that you have the opportunity to hear every talk – even the ones that you can’t attend. I love this. I have always been torn in making a schedule where I’d get to see everything I am interested in. This year we can. We get to hear every lecture.

We have more keynote speakers this year, and more keynotes from naturopathic physicians, that will not only be educational, but also inspirational. The Convention theme is “Composing Effective Patient Care” and fitting this theme we will learn how tones and music affect our health.

I am so incredibly grateful to everyone who has put so much time, thought, and effort into making this Convention so incredible. I am more excited than ever to be attending. (Well, maybe I’ll be more excited next year when I won’t have any Board or Convention responsibilities. We’ll see.)

We are so lucky to get to meet again at the jewel of the desert, the Arizona Biltmore. All who have been there know that it is the perfect location for us to connect with friends and make new ones; to sit in on some great continuing education talks, and celebrate our profession.

I hope you will be there this year. It is not to be missed as a source of rejuvenation for your practice and your soul.

Chain Reaction

By Lise Alschuler, ND, FABNO
AANP Past-President (2008-2009)

Photo by Don DeBold via Flickr, used under the Creative Commons License.

There is an interesting and, frankly, ear-splitting phenomenon occurring in my household. We love birds, so we installed a variety of feeders in both our back and front yards. We diligently fill the feeders as they are drained by hungry birds. Our efforts are worth it. We are treated to a plethora of warblers, wrens, finches, woodpeckers, chickadees, doves, and hummingbirds. The colors are spectacular and we grin with satisfaction at the busy chomping occurring outside of our windows.

We are not, however, the only ones grinning. Our neighbor’s cat now loves us, or rather our yard. Not only can he sit in-wait for a bird, but the seed droppings have attracted a variety of other delectable critters. We have what seems to be several families of chipmunks and squirrels that come to eat the discarded seeds on the ground. Unfortunately, the cat has made off with quite a few of these little ones.

And that brings me to Nora, our dog. Upon waking in the morning, after a good stretch, she eagerly trots out of the bedroom and hustles down the stairs. She gains momentum as she goes so that by the time that she reaches the main floor she is galloping towards the bay windows in our kitchen nook. With her tail a blur, she carefully scans the yard. She is usually rewarded with one, and then several more, chipmunks; and on a good day a squirrel; and on a particularly phenomenal day, the cat. She greets each one of these critters with a wildly enthusiastic barrage of barking, moaning, squeaking and (dog) talking. The bigger the animal, the louder she is. Unfortunately, our house has wood floors and minimal carpeting, so her barks bounce off the interior of our home with ear-splitting volume. Inevitably, after about 10 seconds of this cacophony, we command her to stop. She does, but proceeds to whine/talk/moan at the world on the other side of the glass. Exasperated, we often let her out on the porch where she barks her way into the upper hand and clears the lawn of all creatures – winged and tailed. And then there is blessed peace and quiet. She comes in content, we settle in, and soon the birds come back and it all starts over again.

Despite the fact that we are probably losing the upper register of our hearing, we just won’t take the bird feeders down. We recognize that we are completely responsible for initiating this chain of events and, as such, have no right to complain. It is a daily lesson for me too as I can’t help but wonder what other chain of events I have unknowingly or inadvertently set into motion. Wondering about that also gives me pause whenever I start to blame someone for something as I realize that there is very likely possibility that a long series of events, decisions, and situations led up to what I see before me.

Actually, just about everything seems to work this way – illness included. A sickness is usually the result of a long series of events, decisions, and circumstances. What we see manifested is the tip of a vast iceberg of interconnections. Perhaps, spending some time taking a look underneath would be a good idea, and certainly recognizing the ever-present connectivity in the world gives us deeper understanding and, ultimately, compassion.

President's Message: A Summer of Community

By Carl Hangee-Bauer, ND, LAc
AANP President

May was a wonderful month for the AANP and the naturopathic profession. Our annual Federal Legislative Initiative (aka the DC FLI) and our historic meeting with the AMA were significant successes. Thankfully, there has been a period of calm in my AANP duties before beginning to ramp up our summer activities, culminating with the ever-wonderful AANP Convention in August. It’s always good to have these more quiet times to reflect on all the trends and projects in progress, as well as take a few deep breaths. Having just returned from a Hawaii vacation, I feel refreshed and ready to focus on the next steps, and to see you all in August.

Summer is a season where we tend to get out more and be with others. The longer days and warmer weather foster opportunities like picnics, beach time, barbeques, and other activities that reinvigorate and deepen our connections with friends and family.

The naturopathic community reflects this greater seasonal trend. In early summer, the various elements of our profession begin to communicate more frequently as August approaches. Committees of both the Board and House of Delegates are meeting in preparation for the business of the convention. Our scientific community is busy preparing for the Naturopathic Research Summit on August 16. Students and NDs are preparing for the ZRT Cup.

At least as important as these formal relationships is the gathering of our tribe. This year we find ourselves back at the Biltmore in Phoenix, the most popular site for the AANP Convention, as well as at the East Coast remote convention site in Stamford, Connecticut. At both venues we will come together to learn new skills, find out what’s new in our field, be exposed to new products and diagnostic tools, have fun, and reconnect with our old friends and acquaintances. The latter is one of my favorite reasons for attending the convention. It is the one week each year that I can immerse myself in my profession and deepen my relationships with my colleagues. This always leaves me reinvigorated when I return to my practice.

Whether you are an AANP member or not (why not?), please join us at either site and experience the uniqueness of our community and the joys of being together.

A few reminders:

Vote! This year we are electing a new Treasurer to the board as well as three board positions. We have eight people running for these three positions so it will prove to be a competitive election. Packets containing candidate statements and other materials will be mailed to Members shortly. Voting will begin online on July 17 and continue into the Convention until August 19.

Nominate one of your colleagues for an award. The AANP is calling all of its members to nominate qualified candidates for the 2011 AANP Physician of the Year, Corporation of the Year, VIS, and New!!! Champion of Naturopathic Medicine Award (the "Champion Award"). This year's award recipients will be recognized at the closing banquet of the AANP's 26th Annual Convention and Exposition on Saturday, August 20, 2011, in Phoenix, AZ. All nominators and nominees must be members of the AANP in good standing. Click here to learn about the individual awards and download the nomination forms.

I am already thinking about who will get this year’s Presidents Award. So many deserving choices…

Our unity is our strength, and our community – represented by the AANP – is the vehicle we have to tell the wonderful story of naturopathic medicine. I invite all of you to help us build it even better. There is much to do. So, with all of the changes in health care, advances in medical knowledge and trends, and successes in our profession, the AANP Convention is the place to be to digest, absorb and grow – and connect.

I look forward to seeing you all there.

'Til Death Due Us Part

By Bill Benda, MD, FACEP, FAAEM

Dr. Jack Kevorkian speaks at UCLA in January 2011. Photo by Halebtsi via Wikimedia Commons.

Dr. Jack Kevorkian died last Friday in Royal Oak, Michigan, from pneumonia and kidney failure. If you will remember, Kevorkian defied prosecutors and the courts to help terminally ill patients end their lives at times of their own choosing, and paid for his work with eight years in prison after being convicted of second-degree murder in the death of the last of the more than 100 patients whose suicides he assisted.

So why is such ancient history relevant to us today? Because the fact is that our unprecedented longevity, courtesy of medical technology, often brings with it incalculable pain to patients, families, and the collective economy. I clearly recall the doctor-as-god mentality of the 1970s and ’80s, with white-coated knights heroically battling death by whatever means available, unaware of and unchallenged by the wishes of the afflicted patient. This mindset has not disappeared from our professional ethic, as we find ourselves compelled to combat the incurable cancer, tube feed the severely compromised newborn, or pump the heart of the nursing home patient whose time has come to stop beating.

So where does the integrative medicine community stand on this issue? I am not aware of any research, educational conference, or journal article that has engaged our attention and conversation on the topic of facilitating another’s desired death. Dying a good death, yes. “Dying healthy,” our integrative goal for the terminally ill, that too. Reincarnation, survival of consciousness, illness as teacher, wounded healers; all discussed, explored, philosophized, and meditated upon. But not the uncomfortable social issue of actually helping another to end the journey of living. We strive to be in intimate partnership with our patients, sharing in their spiritual path as well as caring for their minds and bodies. But how should we respond if asked to participate in alleviating another’s torment through an ultimate act compassion? Or is it felony? Does our holistic philosophy lean either way? Or do we hesitate lest the wrath laid upon Jack Kevorkian visit our young and vulnerable profession?

With baby boomers heading over the hill like lemmings in the next few decades and Alzheimer’s predicted to be epidemic by the year 2020, it is time to clarify our professional stance on this issue. I personally believe that we serve each patient best by respecting their authority over what is to be their last earthly act, yielding to them ultimate control over what has become their last earthly possession. Of course the topic is fraught with legal, political, and moral jeopardy. But I am certain that this is a conversation whose time has come, a time to grapple with our responsibility to facilitate both a good life and a good death for our patients. Kevorkian’s advocacy for the right of the terminally ill to choose how they die is widely credited with sparking a boom in hospice care in the United States, encouraging physicians to become more sympathetic to their pain and more willing to prescribe medication to relieve it. We should do no less.

Will Asparagus Cure Cancer?

By Jacob Schor ND, FABNO

Photo by La Grande Farmers' Market via Flickr, used under the Creative Commons License.

If you have cancer, you have likely read that asparagus will cure it. A letter gone viral online claims this. If you haven’t seen it yet, it’s only a matter of time until a copy is forwarded to you by some well-meaning friend or relative.

Those of us who specialize in naturopathic oncology hear about this asparagus business often from our patients, many of who assume the information is true. It’s not.

There is no reason to believe that asparagus will cure cancer. It may actually make a few cancers worse.

Here is what we do know about these claims:

The “Asparagus Cure for Cancer” first appeared in print in the February 1974 issue of Prevention magazine. A second, similar article was printed in the December 1979 issue of Cancer News Journal, a magazine once distributed in health food stores. Both articles claim that a dentist named Richard R. Vensal discovered that eating asparagus could cure cancer.

According to the letter, a cure can be achieved by consuming four tablespoons of pureed cooked asparagus twice a day. Improvement is supposedly seen in two to four weeks.

Unfortunately there is little reason why we should believe this information. Richard Vensal never had anything published to substantiate this claim.

There is one study from 2009 that suggests asparagus has an anti-cancer effect. Chinese researchers reported that a chemical, which they named asparanen A, showed an anticancer effect when added to liver cancer cells.ⁱ

No studies describe the results of feeding asparagus to animals with cancer. Nor are there any published clinical trials on giving asparagus to human cancer patients.

It is certainly widely understood that diets high in vegetables are anticancer. Yet no evidence singles out asparagus in particular, suggesting it has an anticancer effect. There may be some health benefits from eating asparagus because it is a vegetable, but there is little reason to think that asparaguses are special.

In contrast there is substantial information on the anticancer effect of other vegetables. For example, a current search of the National Institute of Health’s National Library of Medicine, lists 597 published articles related to the anticancer effect of broccoli.ⁱⁱ A search for published papers on garlic and cancer yields 648 references.ⁱⁱⁱ

There are only two clinical trials involving asparagus and humans. One paper published in 2009 describes a study in which patients with high blood pressure took a combination of parsley and asparagus extracts in the hope that their blood pressure would go down. Unfortunately, no effect was seen.^iv An earlier study published in 2008, reported that a combination of asparagus and elderberry extracts helped patients lose weight.^v Losing weight is not curing cancer.

While there is little reason to think that asparagus will cure cancer, there is good reason to think that asparagus may make some cancers, in particular acute lymphoblastic leukemia (ALL), worse.

There is a long established link between asparagus and leukemia. In 1953, John Kidd discovered that blood serum taken from healthy guinea pigs, if injected into mice, killed leukemia cancer cells.^vi It wasn’t until ten years later that John Broome explained why. Guinea pig blood contains an enzyme called l-asparaginase, which breaks down the amino acid l-asparagine. Healthy cells make l-asparagine, but certain leukemia cells do not. These leukemia cells must rely on nearby healthy cells to supply them with l-asparagine. The enzyme in the guinea pig blood breaks down the needed l-asparagine depriving the cancer cells of this chemical that they need to grow.^vii

L-asparaginase enzyme is sold as a drug (Elspar) and is now part of the standard protocol used to treat acute lymphoblastic leukemia (ALL). Taking the drug decreases l-asparagine and starves the cancer cells. Most types of cancer do make l-asparagine, so Elspar is only useful in treating a few specific cancer types.

As the names hints, asparagus contain l-asparagine. Eating asparagus would seem ill advised for people who have cancers that respond to l-asparaginase. This enzyme may be useful in treating lymphoma and multiple myeloma.^{viii ix} Eating asparagus may make all of these cancers grow faster, most especially ALL.

People diagnosed with cancer are often desperate to do everything in their power to fight the disease. They grasp onto every story and rumor about anything that might possibly help them. The myth that asparagus cures cancer is a good example. Eating daily doses of asparagus will not cure anyone. Some of these people may actually worsen their situation.

A wiser course of action than believing everything you read online would be to consult a medical practitioner who specializes in naturopathic oncology. There is ample knowledge and evidence that dietary changes and specific foods and supplements may be useful in fighting cancer. It makes sense to base these diet and food choices on evidence and knowledge rather than web-based ‘urban myths.’ When you need specialized knowledge go to a specialist.

The Oncology Association of Naturopathic Physicians (OncANP), an affiliate of the American Association of Naturopathic Physicians, lists naturopathic doctors who specialize in caring for cancer patients on their website: www.oncanp.org

This group tests and provides board certification in naturopathic oncology to those members who meet specified standards of education and experience.

If naturopathic physicians are specialists in natural medicine then OncANP members are specialists in using natural medicine in an oncology setting.

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ⁱ Liu W, Huang XF, Qi Q, Dai QS, Yang L, Nie FF, Lu N, et al. Asparanin A induces G(2)/M cell cycle arrest and apoptosis in human hepatocellular carcinoma HepG2 cells. Biochem Biophys Res Commun. 2009 Apr 17;381(4):700-5.


ⁱⁱ To search yourself, go to: http://www.ncbi.nlm.nih.gov/pubmed?term=broccoli%20and%20cancer


ⁱⁱⁱ To search yourself, go to: http://www.ncbi.nlm.nih.gov/pubmed?term=garlic%20and%20cancer


^iv Chrubasik S, Droste C, Black A. Asparagus P(R) cannot compete with first-line diuretics in lowering the blood pressure in treatment-requiring antihypertensives. Phytother Res. 2009 Sep;23(9):1345-6.


^v Chrubasik C, Maier T, Dawid C, Torda T, Schieber A, Hofmann T, Chrubasik S. An observational study and quantification of the actives in a supplement with Sambucus nigra and Asparagus officinalis used for weight reduction. Phytother Res. 2008 Jul;22(7):913-8.


^vi H. D. Moon Presentation of the Gold Headed Cane to John G. Kidd. February 24, 1973. Am J Pathol. 1973 October; 73(1): 1–6. PMCID: PMC1904051
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1904051/pdf/amjpathol00248-0005.pdf


^vii Broome JD. Evidence that the L-asparaginase of guinea pig serum is responsible for its antilymphoma effects. I. Properties of the L-asparaginase of guinea pig serum in relation to those of the antilymphoma substance. J Exp Med. 1963 Jul;118:99-120.


^vii Jaccard A, Gachard N, Marin B, Rogez S, Audrain M, Suarez F, et al. Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relapsing extranodal NK/T-cell lymphoma, a phase 2 study. Blood. 2011 Feb 10;117(6):1834-9. Epub 2010 Dec 1.


^ix Taylor CW, Dorr RT, Fanta P, Hersh EM, Salmon SE. A phase I and pharmacodynamic evaluation of polyethylene glycol-conjugated L-asparaginase in patients with advanced solid tumors. Cancer Chemother Pharmacol. 2001;47(1):83-8.