Reflections from the Philadelphia Trans Health Conference 2013

What a phenomenal catalyst for change. June 13-15 was the 12th annual Trans Health Conference in Philly. It was a massive collection of workshops on many different aspects of Transgender, Transsexual and differently gendered health and healing including medical, legal, spiritual, practical aspects, self-empowerment and so much more. I was honored to be a presenter this year on Naturopathic Medicine and Trans Health. It was my first time attending the conference, and I am so impressed by the caliber of the event. I primarily attended medical style workshops including presentations on the most recent research being done with the trans community.

My talk was a great learning process for me. Not only from the questions asked by the diverse and well informed crowd, but also as a reflection of self. I am very comfortable in the trans community, consider myself an ally, and am aware of the multidimensional and sometimes fragile nature of trans identities. And yet, twice during my presentation I wrongly identified someone as a woman and a man when calling on people for questions. Under pressure, my highly educated nervous system switched back to my reptilian brain of the binary He-She world – and this with all the *knowing* that I have of the great diversity of gender expression. I was disappointed in myself.  It is a lesson that in working with this community, it is especially important to be conscious of language. The old ways of thinking are simply not progressive enough to enter the dialogue. For example, when referencing  people, we as a society need to step outside of classifying people by sex (and race.) Instead of saying “the woman in the yellow shirt”, say “the person in the yellow shirt is ….” The majority of the time our binary classification may be right, but there is a significant proportion of times when our 2D classifiers are actually incorrect, and those can be very painful moments for the individual inhabiting the misread gender identity.

I also talked about adrenal health, and was pleased to learn of new research that evidences salivary cortisol levels are indeed raised higher in the transitioning trans population than in controls. Meaning – stress is huge. Everyone working with trans people of all identifications will need to do stress management and adrenal support. Adrenals are also a source of endogenous hormones including DHEA, which could be a resource for transmasculine and transfeminine people not taking hormones as it has the potential to shift to both testosterone and estrogen internally.  There were many questions about the use of botanicals that have been evidenced to have steroid-like action. This is an area I need much more clinical experience in.

I was heartened to meet 3 other Naturopathic Doctors and two herbalists working in this field at the conference, all of who gave presentations as well.  They reminded me of some of the important preventative medicine aspects of working with people on hormone therapies like hypertension, osteoporosis, calcium quality, high cholesterol and so much more. There were also acupuncturists, and ayruvedic practitioners offering other traditional perspectives. Next year I hope to cultivate a workshop where we all meet to share information! I know I was left with more questions than answers.

I learned important information about our trans youth, and ways to support them better from both a practical level in schools, around mental health, and medically. Dori Midnight, a Massachusettes healer and fairy witch did workshops in mental health, herbalism and ancestral trans magics. I also got to share a room with her, which was a delightful meeting of the minds with gluten-free snacks. There were many sessions on identity development and closed meetings for specific gendered health care needs that looked inspiring and transformational. There were many fantastic workshops I did not get a chance to attend, including a 2 day medical training stream which I will certainly do next year.

Overall, the experience was one that provoked intense introspection and profound leaps of knowledge. It was an event that is crucially important to modern medicine, to understand not only the vernacular but also the urgency of the need for competent health care providers AND self care within the transgender, transsexual and gender non-conforming communities.

A few links and resources from the conference:

http://www.trans-health.org/

http://www.dorilandia.com/html/home.html

http://thirdroot.org/

http://www.rainbowhealthontario.ca/admin/contentEngine/contentDocuments/Gender_Independent_Children_final.pdf

www.riverstoneconsult.com

www.gendercreativekids.ca

www.fenwayhealth.org/transhealth

 

 

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Naturopathic Trans Health 101

** This is a handout from PTHC June 2013 – Please email me at thewrightnd@gmail.com with your experiences using natural medicines in transition! **

Naturopathic Medicine is: licensed in the state of Maine and many other states and Canadian provinces. We provide primary care using medical and alternative medicine. Naturopathic philosophy is based on the premise your body knows how to heal itself, and medicines from nature can help you overcome obstacles to health.

Naturopathic Doctors tools are: Botanical Medicine, Homeopathy, Nutrition, Lifestyle Counseling, Stress Management. Some ND’s also provide hands-on treatments (Chiropractic, Massage, CranioSacral Therapy,) Prescription medication (thyroid and female hormones, antibiotics, some Lyme medications, topical products),  Acupuncture, Traditional Chinese Medicine and IV Therapies.

FOUNDATIONAL NATUROPATHIC SUPPORT – FOR ALL GENDERS

  • Green tea 1-2 cups daily– anti-cancer, antioxidant, immune system support
  • Adrenal support – adrenals are a major source of hormone production when the gonads are taken out of the picture as is evidenced in menopause and andropause. B5, vit C, Siberian ginseng, Ashwaganda, Rhodiola, Licorice.
  • Probiotics – the digestive tract is the seat of our vitality and overall health.
  • Cruciferous vegetables, fresh ground flax seeds, green tea, sprouts all enhance excess (endogenous and environmental) estrogen elimination – important for every body!

GENERAL TRANSMALE SUPPORT

–       Support adrenals with herbs known to increase testosterone production.

–       Testosterone metabolizes into Dihydrotestosterone (DHT) – a biologically active metabolite of testosterone 30x more potent because of its increased affinity for T receptors. DHT is known to promote hair loss. This conversion can be modulated with SAW PALMETTO – stops the conversion of T –> DHT. PLus ZINC 10-30mg daily.

–       Nettle Tea – decreases bound T/ increases free (active) T, lymphatic support.

–       Reservage Keratin Booster  – prevention of baldness.

GENERAL TRANSWOMAN SUPPORT

–       Breast health! Reduce methylxanthine chemicals found in coffee, black tea, caffeine, and chocolate. At least monthly breast massage for lymphatic health using herbal oils.

–       Aerobic exercise.

–       Freshly ground flax seeds help the body eliminate excess estrogen – add to smoothies or yogurt with fresh fruit and maple syrup. Cancer prevention.

–       What is a phytoestrogen? Plant compounds that bind to estrogen receptors throughout the body.  Soy Isoflavones, Alfalfa (Medicago Sativa), Burdock (Arctium Lappa), Dong Quai (Angelica Sinensis), Evening Primrose, Pau D’arco (Tabebuia Avellanedae), Red Clover (Trifolium Pretense), Saw Palmetto (Serenoa Repens.)

–       Organic non-GMO soy 1-3 times week if tolerated.

–       HRT Companion by Vitanica** Great prevention product for long term use.

–       Reduce systemic inflammation for optimal long-term health – estrogen is protective for heart and bone health, but it can also be inflammatory. How to reduce inflammation? (CRP, homocysteine measures on bloodwork.)

SEXUAL TONIC HERB REVIEW– from The Male Herbal by James Green

Ashwaganda – WITHANIA SOMNIFERA Withanaloid chemicals resemble steroids biochemically. They are classified as an adaptogens to enhance libido and restore fertility and sexual potency.

PANAX QUINQUEFOLIUM – American ginseng.  PANAX GINSENG – Asian Ginseng. All ginsengs provide ginsenoside compounds that effect hormonal balance. Their overall chemistry supports strong sexual function through tonifying activity. They can also increase nitrous oxide levels, improving blood flow where needed. Panax ginseng is classically only used for men as it is too Yang for women’s health unless specifically prescribed.

Horny Goat Weed – EPIDEMIUM SAGITTATUM, EPIDEMIUM GRANDIFLORUM Exhibits moderate androgen-like effect.  Contains flavonoid ICARIIN which is a cGMP-specific PDE-5 inhibitor (like Cialis, Viagra and Levitra)

Muira Puama  – PTCHOPETALUM OLACOIDES Increases circulation, nervous system tonic, improves sexual weakness and diminished sexual desire in all genders.

Maca – LEPIDIUM MEYENII, L. PERUVIANUM ** Nutritive tonic for all genders. Simulates ovarian and erectile functions. **  – Could restore fertility for FTM’s who decide to want to conceive after testosterone use.

Gokshura  – TRIBULUS TERRESTRIS ** Prostate and urinary system tonic. Contains saponin, a steroidal plant chemical to improve libido with impotence. Improves sexual desire, fantasy life and sexual self-confidence. May prolong duration of intercourse before ejaculation. Increases endogenous LH levels. May stimulate endogenous testosterone production in men and women.  ** May also stimulate ovarian or testicular action in ways that are not desired. Use with caution.

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#TTC – Safe Treatments for Fertility & First Trimester Anxiety

The work of becoming/being pregnant marks a time in a woman’s life when the game changes. Alcohol is no longer an option for stress management. Most herbs and even common teas are viewed with suspicion, and many medications are frowned on. Many of our crutches for managing the stresses of daily life are taken away, and the stress of in/fertility is added. However, there are natural treatments available for this time period to reduce stress, ease anxiety, and support a healthy first trimester.

Flower Essences are very safe for all expecting and #TTC moms, and are especially useful for women using multiple fertility and metabolic medications as they have no interactions or side effects! Flower remedies are literally essences of the particular flower in a brandy solution. Bach flower essences are the most commercially available. FES (Flower Essence Society,) Alaskan Essences, Perelandra and more are other well respected flower essence brands. Bach has 38 different flower remedies available; however the following are especially pertinent for fertility and first trimester. Dosage is 3-5 drops in water 2-4 times daily or as needed. The very small amount of alcohol in these medications will not cause any fetal problems as it is so minute a dose.

Aspen: For apprehension and vague fears

Gorse: Brightens perspective and increases optimism.

Holly: For envy or jealousy of others

Larch: Gets one out of the success/failure paradigm and increases self-confidence

Wild Rose: Restores interest and joy when feeling apathetic or resigned.

White Chestnut: Restores a peaceful mind when caught in repetitive thoughts

Botanical Medicine: Some herbs are appropriate for this time period, however most herbs are best set aside until the pregnancy is well established or beyond breastfeeding. One herb that is a #TTC and first trimester best friend is viburnum prunifolium otherwise known as black haw. This is different from viburnum opulus aka cramp bark – do not mix the two! Black haw quiets an “irritable” uterus, and prevents miscarriage. It is very safe and quite effective. I recommend 1/4 to 1/2 tsp daily for the first trimester as needed. For questions and concerns, refer to your local Naturopathic Doctor who can take your full history and prescribe according to your individual health care needs. Oatstraw or avena sativa is also a wonderful tonic that is nourishing to the body and calming to the mind. This herb is best taken as a tea. It is gluten free, hydrating with rich minerals (therefore great for morning sickness) and soothing to frazzled nerves. Valerian is perfect for nighttime anxiety. It is safe in pregnancy, breastfeeding, and for pediatrics. This is Mother Nature’s truly sedative herb. Used in doses of 5-30 drops before bed, this can help quiet the mind and improve the duration and quality of sleep. I like it as an alcohol free (glycerite) tincture as the taste is slightly sweeter than the alcohol based formula. Capsules are also an option although I prefer the smaller dosing options of the liquid form. (Valerian is very well researched, please contact me for a formal monograph if desired.)

imagesFinally, lavender essential oil has a time honored place in the treatment of anxiety.  For those whom lavender has a calming effect you can use lavender products liberally that have the real essential oil in them – avoid synthetic fragrance analogues. There are now lavender essential oil capsules that are quite effective for treating occasional or situational anxiety. These act quickly and safely to diminish feelings of panic, irritability and stress. Typically essential oils should not be used internally during pregnancy, so these lavender caps are best used only until the day of ovulation. There is a lavender glycerite tincture also available which can be used sparingly while pregnant in doses of 1-2 drops for anxiety and panic as needed. There is some (internet) controversy surrounding the use of lavender in pregnancy; however, it is not listed in any of the classic literature as a herb to avoid in first trimester.  My opinion is that if this botanical medicine is the one thing that works to soothe your fears, use it in moderation. If it increases your anxiety due to the multitudes of internet opinions, avoid it! Here is a link to a well researched blog post on the safety of lavender essential oil in pregnancy: http://roberttisserand.com/2011/07/lavender-oil-and-pregnancy/

Acupuncture and Registered Massage Therapy are also fabulous safe care therapies for anxiety and stress while #TTC. Acupuncture has a proven track record of efficacy when it comes to enhancing not only assisted reproduction but also all conception. Studies have shown that weekly acupuncture greatly reduces the rate of miscarriage during first trimester, especially for women with a previous miscarriage. This is in part due to its ability to support the expectant mom through the first 12 weeks. The therapeutic touch offered by massage therapy also has the ability to soothe anxiety, ease depression, and support the physical changes of pregnancy. The resulting relaxation offers an anxious expecting mom a few moments to quiet the mind, which can have great positive effects overall. It is important to see an acupuncturist or massage therapist trained in pregnancy massage as there are specific techniques and positions used for this treatment.

All in all, this is such a time of mystery, of waiting, and of trust that it can be overwhelming to have to “go with the flow.” Every couple experiences some level of anxiety, and some have a very hard time as #BFN’s happen again and again.  Flower essences, black haw, oatstraw and lavender glycerite are natural remedies that any couple can use to support their own mental and emotional wellness on the road to becoming a family. There are many more herbs, vitamins, and therapies available for #TTC and expectant moms that are based on the individualized medicine offered by a licensed Naturopathic Doctor.

Links and Resources:

http://www.gowonderworks.com/flower_essences

http://www.bachflower.com

http://www.fesflowers.com

http://www.biomedcentral.com/1472-6882/12/20

http://www.fertilityfactor.com/infertility_acupuncture.html

http://americanpregnancy.org/pregnancyhealth/prenatalmassage.html

 

 

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#TTC Obsession – Confessions

Getting pregnant is scary and exciting. The process of wanting to conceive and then waiting to find out…. not priceless. I am intimately aware of this as a Naturopathic Doctor with a focus on In/Fertility. I have also been privately preparing for this moment of my late 30’s when I am ready to conceive.  I have treated and supported many women through this process already. And here I am, alone with my OPK stick in the bathroom, discerning the workings of a secret universe. CONCEPTION.

I am amused at my complete immersion in the consuming nature of trying to predict my own ovulation. I cannot believe how often I think of the subject. I am constantly turning the information over in my mind. I read fertility forums online to gather information; I delve into friends’ personal experiences. Medicine looks so different when one is the patient! Suddenly there are a thousand things I do not know… Ovulation Predictor Kits are only the beginning.

And, in the obsession of pregnancy, it becomes everywhere. Books and television remind me that women have been torturing themselves about the ability to get pregnant forever! First, it was conceiving a boy, and whether or not the First Son would be born.  With rampant infertility, the collective obsession has turned to the BFP and away from gender preference.

We want to be able to control this event with every ounce of heart and mind. We are so used to be able to create what we need, if we only put enough effort into the act! It is maddening to have to develop techniques like trust and patience to achieve our highest goal…. and yet that is what it comes down to in the end. Do we hold the ultimate responsibility of whether or not life occurs in our very body?  It is appears to be the hugest responsibility, and yet it is one we cannot. create. on. our. own.  As my friend said yesterday, “We are accomplished and often privileged women! Powerful creations, and yet…” we cannot read what should be the simplest signs of all from our flesh. Are we ovulating today? Are we pregnant? It’s a huge pressure.

For same sex couples and single folks, there is the additional stress of genetic material to procure. The art of conception (often) looks very different for lesbian and gay couples. Not only will the inseminations need to be precisely timed, but the acquisition of said tools of conception must also be arranged. The cost of becoming pregnant begins with the very first try, an additional ingredient in the pressure-cooker of preparation. (In a call-out to women with biologically male partners, I do understand that when women hit the fertility clinics, we are all in the same machine.  The sex or gender of our partner becomes much less relevant although issues of accessibility to and cost of genetic material remains an additional stress.) It’s a wonder any of us become pregnant at all! But we do, in every increasing numbers.

The minute details, test results, and potential scenarios become an endless gerbil wheel of anxiety. It is important to step back from your own fertility and restore some normalcy to your daily routine. I was wound up over the timing of what was only a pre-cycle. Imagine how physically stressed out I could be for the real thing! One of my friends advised me after her first birth – make it fun. Try to relax around it. And she laughed knowing how hard that would be. I suggest distracting yourself as much as possible from thinking the same old anxious thoughts.  HOW? Listen to music that makes you sing. Watch a movie that engages you. Make time for friends or family who you like talking to and who are interesting. Write in a journal so you can get the thoughts out of your head and onto paper. The less time that is spent obsessing about the timing or prediction of said events will be in your best interest overall!

There is no conclusion to the story. The (new brand of) OPK kits wait for next cycle in my bathroom cupboard. I am going to pray for myself, light candles of hope, and continue to make the daily small offerings I do towards pregnancy – high quality prenatal vitamins, DHA essential fats, green tea, and other things appropriate for my personal care. My sweetheart and I also have a plan B, and C in place to rely on. When I get in the hamster mind of prediction anxiety again, please remind me of this post. Stress inhibits Ovulation!

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Mediterranean Adventure II

We were concerned that traveling Gluten Free would be tough. And not even just gluten free – I can’t eat potato or corn, and my sweetheart can’t have rice. So, we were both headed abroad knowing that food choices could be tough. We had the good fortune of staying with family, so for most of the journey we had a kitchen and fridge to stock with staples we could rely on. For me – mostly eggs, rice cakes, delicious olive paste, incredible fresh green olives. For my sweetheart – she had the bonus of finding gluten free bread, plus corn cakes, jam, and yogurt. Then we  shared fruit, veggies and local cheeses. She brought her own corn pasta, and I had no trouble finding rice pasta as needed in the local “Veritas” (organic) market for family dinners. We even found quinoa! Local markets and/or supermarkets also had lovely fresh meats, fish and produce for family dinners. We both brought some snack bars (Kits Organics for her and Luna Protein for me) as well as trail mixes. Of course, there were also lots of delicious treats we could both have. Europe has an impressive array of yogurts, puddings, and other cold delights in small jars. (Less ice cream though, in the freezer sections.)

Overall, food turned out to be less of a problem than we feared. When going out, my sweetheart was invariably able to get “patatas bravas,” a local dish of fried potato with a yummy spicy mayonnaise. Tapas (or pinxtos as they are called in San Sebastian) were harder for me to navigate, so often I just didn’t. Dinners out were easier – I could almost always find some delicious fish or chicken and vegetable options in the Menu del Dia – a 10-15 Euro daily menu with 3 courses and wine and coffee included. As my sweetheart is more sensitive to gluten and cant get away with any exposure, she usually stuck to Ensalada Mixta (salad, tuna, olives, and hardboiled eggs) with a potato side dish. All in all, it worked out well. We weren’t able to sample the breadth of Spanish gourmet cuisine, but we still had some flavorful dishes and local delicacies.

As a Naturopathic Doctor, I was constantly assessing the Mediterranean Diet and to see how the classic reputation of the region matched the real fare. As I suspected, there was plenty of bread, cheese, sugar, and packaged foods available as in the Standard American Diet (SAD.) There were a few noticeable differences though that may account for some of Europe’s lower body weights and improved life expectancy. First, there was no bacon. Yes, “bacin” was on some menus, but it was peameal-style bacon, pan-fried and not the true “bacon” of North American fame. Second, beef was rare to see on a menu or in the supermarkets, and was quite expensive. This made sense as we drove across the country, as there were very few cows. European terrain is not made for grazing the way Texas is.

Finally, and perhaps most impressive to me was the rest stops for food along highways. Each one was set up like a classy buffet restaurant, complete with chefs behind the food casing presenting grilled vegetables, roasted chicken, and a wide arrays of sandwiches, jambon, fruit and cheese choices. There were mini bottles of wine and cans of beer at every register, as if instead of being on a roadtrip one was intentionally stopping at that location for a meal. And stop everyone did, even for coffee. The American in me was shocked that people were literally getting perfect little iced espressos and walking to sit down and drink it before they got back on the road. We are such a to go culture! The contrast was very strong, and was I think the best illustration of the differences between our SAD diet culture and that of the Mediterranean. They sit down and savor a meal, a coffee, and a moment in time. It’s a lifestyle, a way of thinking, and a paradigm. We eat on the go, “para llavales”. We Rush, wolfing down food, eating mindlessly as we multitask and gulping down our beverages while we push on ahead. And we pack on the pounds and generate chronic disease as we go along, coercing our nervous systems into simultaneously digesting and running at the same time.

I am still filtering through layers of impressions, photos and reflecting on the whole experience of world travel. I highly recommend Spain to anyone – Barcelona is the second most popular tourist destination in the world, and well worth the hype. Traveling gluten free was not a problem; we were able to find great local resources and food options, especially for a food adventurist. For those who can eat gluten, there is an incredible world of tapas out there just waiting your arrival! But do yourself a favor – eat like you have all the time in the world.

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Mediterranean Adventures

We are traveling in Barcelona and parts of Northern Spain for two weeks ~  visiting ex-pat family and having a European vacation while Spring comes to the Northern US. As many Americans have often commented while traveling in Europe, the difference in body weight here is remarkable. Simply put, very few people are overweight. And, despite the smoking, wine consumption and late nights, it is known that Europeans live longer than Americans on average. So what is the big difference? Eating patterns, Diet, and Lifestyle.

By Diet, I do not mean calorie restriction, portion control or eating plans. I mean, a style of food intake linked to cultural patterning and local food options. The Mediterranean Diet has been a source of scientific study for several decades because European countries centered around the Mediterranean Sea have statistically lower levels of heart disease, diabetes, and other chronic diseases. It is a nutrition pattern that includes a foundation of olive oil, fruit, vegetables, fish, seafood, whole grains, pasta and potatoes. This is complemented by smaller amounts of eggs, dairy and chicken. Red meat and sweets are eaten occasionally. It is also a practical nutritional plan – meat is expensive, tomatoes and olives are not! The “Mediterranean Diet Pyramid” is a famous illustrated depiction of the basic concepts. (See Resources below for a great downloadable version.)

We noticed a few real differences right away.

1. There is no To Go – people sit to eat their food and drink their coffee.

2. There is no half and half or cream for coffee. There are no Grande or Venti coffee options. A coffee is a small cup of strong brew with or without steamed milk and sugar.

3.  The cities are made for walking and biking! With bike lanes and mazes of small windy alleys and wide picturesque boulevards the cities inspire pedestrian activity.

We haven’t quite adjusted to the concept of siesta time yet. In fact, between jet lag and our American ways, we have almost invariably set out right as the shops roll down their doors and the streets close up for the afternoon 2-5pm rest. This is our goal for the trip – to learn the fine art of Siesta. What an ultimate luxury!

US life expectancy links https://www.wsws.org/en/articles/2013/01/11/life-j11.html and http://www.economist.com/blogs/buttonwood/2013/01/life-expectancy

Mediterranean Diet Research: http://jama.jamanetwork.com/article.aspx?articleid=199485

http://www.mayoclinic.com/health/mediterranean-diet/CL00011

Practical Resources: http://oldwayspt.org/resources/heritage-pyramids/mediterranean-pyramid/overview

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Improving Libido with Naturopathic Medicine

Sex, sex drive and inherent libido are all very complex subjects in modern culture, affected by our extremely long TO DO lists tagged onto the ends of busy days. Here is an article I wrote for QueeriesMag.com February 2013 on Naturopathic Medicine to increase sex drive.Let me know what you think!

http://queeriesmag.com/index.php/2013/02/14/on-the-kitchen-table/

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How to Survive Influenza

Herbal medicine is wonderful for any kind of cold and flu. The key to successful use of herbs is to take them early and often. I began with Gaia Respiratory Defense capsules 2 caps every 3-4 hours with lots of watered down juice. I also drank an entire bottle of Apitherapy Wild Cherry Cough Syrup at 1 tbsp every 2-3 hours for the first 36 hours – this is a New England centric product but any herbal wild-cherry or horehound based product would do. If you live in a bigger city Nin Jiom Pei Pa Koa is an awesome Chinese cough syrup available at many health food stores. Mix 1 tbsp of the Nin Jiom thick syrup with hot water for a soothing tea/cough syrup 3-4 times daily.With these two products I was successful in clearing the lungs, and ended up with only some minor sniffles.

“Feed a Cold, Starve a Fever” is an old saying. When you have a fever, your body does not have energy or attention to pay to the digestive system. Most people do not have an appetite anyways, so it its Best Practice to focus on fresh fruit, juice, water, and soup broth. Apple sauce, popsicles and crackers are also good choices. Follow your intuition when it comes to food. Herbal tea with fresh lemon and honey is also healing and soothing. Echinacea tea, or any “throat tea” or “cold tea” will be beneficial. Don’t be afraid to *not* eat if you are not hungry; however make sure you maintain some caloric intake so your body has fuel to fight (unless it is a stomach flu.) Your appetite returning will be a sign of health.

Other things that help fight off influenza – elderberry syrup has tasty evidence based antiviral capabilities. Taking a minimum of  5,000IU of vitamin D and 2000 mg of old fashioned vitamin C will both speed recovery as well. This years flu is highly contagious – please don’t “be brave” and work/shop/be out and about unless you absolutely need to. Ask a friend to pick you up something and drop it off, take time off work, and REST! Everyone else will thank you for it, and you will recover faster in the end, with less complications than if you have suffered through it publicly.

I haven’t had the flu…. ever before. And I had not had a fever since I was a child. Boy, together they make an awful combination! I spent most of the week between Christmas and New Years Eve lying in bed with a face-headache, sweating, chilled, sniffley, and unable to do much more than lay with my eyes closed.However, I did recover rather quickly, without losing more than a couple days of work and a few pounds. During my fever induced vacation, I had time to consider fever medicine, and to mull over how many people have actually died from influenza over the course of history.

Curious as to how this self-limiting virus induced illness could literally wipe out generations, I took to Medscape to better understand why the flu can have such devastating effects.  From the article “Christmas 2009: Years Like This: The Spanish Influenza Pandemic Seen Through the BMJ’s Eyes: Observations and Unanswered Questions” by Tom Jefferson, Eliana Ferron BMJ. 2009;339:b5313 it is clear that it was not a simple case of influenza that killed so many people, but rather a combination of factors including environment, hygiene, medical practices of the times, and a lack of immunity to the European microbial ferment that wiped out staggering numbers of  people. The article states:

” The causes of the high case fatality rate are still unclear, but modern research suggests that the pandemic was a lot more than just a “one germ-one disease” affair. [19] … Agents other than the influenza virus probably played a part. Above all, the environmental explanations of the high [Samoan and Lapp] mortality rates indicate the peril of generalizing across contexts and simplifying causation models. “

In other words, early pandemics were about more than just a flu virus. They were complicated environmental scenarios where subsequent (fatal)  infections developed. Therefore, most of us in modern times are highly unlikely to die from influenza. This is of course, a more serious condition for people who have a defective immune system and for individuals on either end of the age spectrum who are more fragile. So, knowing that one is unlikely to die from the flu or fever, are you more willing to suffer through the symptoms if you knew it would be over sooner?

I was raised with the belief that a fever is an opportunity for “cleansing” on a spiritual and physical level. Fevers up to 102.5 are still considered safe and effective for a healthy person. The heat in the body serves as a natural autoclave, killing bacteria and viruses quickly and effectively. In my upbringing, it was also “burning karma” and an opportunity to cleanse oneself from spiritual burdens. This is what I focused on as my fever climbed from 101.5-102.5. I felt awful and was miserable and in pain. But, I kept telling myself I was in the process of transformation! It seemed to justify the misery in a way. There is of course, a limit to pain and suffering and modern medicine has much to offer. Therefore, I would return to my 400mg of Ibuprofin at night to help me sleep and reduce my pain and fever for the night. After all, sleep is as important in recovery as anything else is. Thus, I do suggest when you or a loved one has influenza, to allow a fever to burn within a safe range up to 102.5 F (Technically a fever is safe up to 104.5F) . Fever reducing medications can always be used as needed when the tolerance level of suffering is reached. Belladonna 30CH is a homeopathic fever reducing medication that can be used safely in children and adults as needed. It acts as a trigger to the body to reduce its thermostat, without actually suppressing the fever like NSAIDS do. This is a great medication to have in your home first aid kit. I was happy to dig mine out at 2:30 am on my second night sick – anything for relief in those sick midnight hours!

A final thought on cold medications – allergy pills, Dayquil, and other daytime cold and flu medications are most likely going to fail in the face of influenza. You are better off lying in bed and letting your fever burn while you try and watch some tv. However, night time is  when I believe some medication can be necessary as most people worsen in the night. No natural cough syrup is going to be as effective a pharmacy brand one. If I am hacking in the night with a cough, I use a pediatric cough suppressant as they contain less alcohol and chemicals than adult ones. Using Nyquil, or Ibuprofen/Tylenol at night to sleep is perfectly reasonable if it actually works for you. (If it doesn’t work, stop taking it and call your Naturopathic Dr for more treatment support.)

In summary – Rest, liquids, soups, belladonna 30ch, wild cherry cough syrup, vitamin C, vitamin D, elderberry, and a herbal formula that treats your constellation of symptoms are all components of successfully navigating a bout of influenza. Allow the fever to burn, whether you view it as a natural autoclave or a spiritual cleansing (or both) is up to you. A cough that lasts more than 7 days, fever above 102.5, or consistent vomiting for more than 36 hours are all good reasons to call your primary care provider and check in.

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A Note from Behind the Curtain

So many patients are looking for answers. As a doctor I know that the best answers are in each individual. Usually, we do not want to know the real answer. We want a pill, or a cream, or a smoothie containing the essential nutrients that will add up to the ultimate results. Dont get me wrong – products will help. Testing can uncover imbalances and deficiencies to be corrected and appropriate formulations to improve symptomology. However… until you are actually ready to change something – that thing- – which needs changing in your personal landscape, it is unlikely that you will find your own true answer to health. I will use myself as an example.

After I graduated from Naturopathic Medical School in 2000, I opened a clinic in downtown Toronto with some of my classmates. Over the next 12 years I developed my professional identity, grew my patient base, and pursued my personal passion of fertility medicine. I had a wonderful partner, a beautiful home and fantastic friends. I was never fully content, despite my abundance. I doubted my career and profession, and was constantly seeking something outside of myself to fill the inherent void. No amount of adrenal supplements, detox regimes or magnesium quieted the inner voice. This was not an organic condition, it was a calling that took me many years to acknowledge.

Eventually, I moved to Portland Maine in March 2011. I sold my clinic, left my clinic faculty position, and my sweetheart and I parted ways. Here, life is different. I smell the ocean every day. I do yoga (occasionally.) I walk the dog. I drink green tea. I am redefining myself as a Naturopathic Doctor and am inspired by the new turns my professional identity is taking. I am becoming a better doctor – the best version of myself. It has been a massively stressful process to redefine my life in my late 30’s. However – the gray hairs are worth the evolution. I am happy in a way I have never been. And it is not because my physical, emotional, or mental health has changed drastically. It is because I have found my own answer.

Not everyone’s answer will involve so many miles and such upheaval. The answer to your own health and wellness questions may simple or complex. Part of my job as a Naturopathic Doctor is to look beyond pills and dietary restrictions to see your truth behind your curtain, and support you in finding your own evolutions. If I can do it, I am sure to believe in you.

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Resolving an Arthritis Flare – for My Dad

Chronic inflammation can cycle into snowballs of pain that catch us off guard. For those with a familial tendency towards rheumatism, arthritis can become quite severe. Joint inflammation usually takes the autoimmune form of rheumatoid arthritis or the inflammatory/ immune joint presentation of osteoarthritis.

It takes time and patience and a good amount of work to manage an acute pain flare. We want a recipe for success to include a small pill and minimal work. Unfortunately, this is rarely the case. To follow is a recipe for treatment of an acute, immediate or aggressive flare up of arthritis/tendon inflammation or bursitis that may be causing moderate to extreme pain and inhibiting mobility.

1.You will need to rest as much as possible for 7-10 days. Plan to stay home and lay low whenever possible. Stand up every 2-3 hours (except while sleeping) for 10-20 minutes of stretching and gentle exercises. Walking in nature, Pilates, physiotherapy, gentle yoga, or  Wii Fit balance exercises good choices to support rehabilitation.

Plan your life accordingly. You may need to work from home if possible, and reschedule activities. This is necessary to address the pain. It is likely your pain and inflammatory levels will be up to 50% resolved by the tenth day of treatment.

2. Take a daily bath if you have access, soaking the affected joints for up to 45 minutes. Use Epsom magnesium bath salts with 10-15 drops of lavender essential oil or a bath salt of your choice. Follow with 20 minutes of icing the affected joint. If you don’t have a bath, use a hot shower and/or hot towels or a heating pad and ice after a shower. 

This plan will not cure your arthritis. This does not replace the need for surgery if you have a fracture or true tear like a labrum or rotator cuff. Do not discontinue scheduled plans prescribed by your physicians and specialists.

3. Start an Anti-Inflammatory Diet. This is best continued until joint replacement is successful; however, it is crucial during the initial rest window. Studies have proven that nutrition is directly linked with inflammation. By eliminating foods known to increase systemic inflammation, you can reduce your own inflammatory load. This allows your body to begin healing. You can google one, find a local holistic nutritionist for guidance, or a local ND. The anti-inflammatory diet eliminates gluten, beef, tomatoes, potatoes, eggplant, peppers, peanuts, soy, oranges, and often dairy. What else can you eat? So many things! Fish, apples, pears, chicken, rice, legumes, nuts, seeds, quinoa, pork, lamb, oats, berries, greens, beets, carrots… the list is endless!

4. The Medicine. Zyflamend- 3 capsules morning and nighttimes daily. This is a modern formulation of 6-10 botanicals to treat inflammation, joint pain and rheumatism using herbal medicine. New Chapter has combined these into an effective and well researched formula called “Zyflamend.” http://www.newchapter.com/zyflamend The PM version also contains a small amount of relaxing herbs which are helpful for supporting a restful attitude during your healing. You may continue this for up to one year’s duration before a break is needed.  This product is safe to take with most narcotic and non-narcotic pain medication including Vicodin, Oxycodone, Ibuprofen, Tylenol 3 and Ibuprofen. However, do not drive while taking the nighttime formulation. 

5. Nordic Naturals Omega Joint Plus – 3 capsules daily with  food. This is a premium joint care formula containing 1500mg of glucosamine sulphate as well as anti-inflammatory levels of EPA and DHA. The product is expensive at ~$50/bottle for one month supply however, it is worth it. Switch to this product during your first month of resolution treatment for best results, and hold your other fish oil or glucosamine supplements. http://www.nordicnaturals.com/en/Products/Product_Details/514/?ProdID=1548

During your 7-10 day acute healing time, you can take your other supplements as well, or take a supplement vacation and focus on the above products only to streamline your protocol.

This is the skeleton treatment plan. This is a great place to start If you do not get the results you are looking for or have trouble adhering to the program, consider seeing a ND in your area. In addition to the above protocol, continue to take your medications for heart, kidney, lung or other medical health conditions. Specific neutraceuticals to address sleep, anxiety, digestion, or other issues may also be prescribed in a consultation. Classical homeopathy is also extremely useful in complex cases. It is safe with complicated pharmaceutical treatments and provides lasting results.

Your pain is a sign that something is wrong, Respecting the pain by changing your every day lifestyle can provide insight into the pathology. Physiotherapy, Osteopathic medicine, Acupuncturem Chiropractic, Craniosacral therapy and other physical medicine treatments are essential to rebalancing pain as well. Z

Side Note; If you drink More than 2 drinks a night, NSAIDS like ibuprofen, celecoxib, Alleve, and other antiinflammatories are not safe for more than 7 days of use for pain. If you have heart failure, either preserved or reduced ejection fraction these medications can damage your heart and kidneys. Seek appropriate treatment from your primary care doctor or orthopedist and disclose your daily alcohol intake as this could lead to life threatening stomach or esophageal bleeding. If you have marooon or black poop, or vomit what looks like coffee grounds, go to your ER immediately,

Pain is a message, Increasing pain means something is worsening. Listen to your pain by doing the above lifestyle changes. If you do not find improvement, follow the resource branches of care with primary care, orthopaedics, rheumatology, psychiatry and physical medicine to get to the root of the cause. Your bones will thank you for it,

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