Without a foundational view of health, it is impossible to treat illness. It is absolutely shocking how little health is covered in medical school, so I thought I’d post my favorite definition, loosely paraphrased from Vithoulkas and Frances. 

Health is freedom on three levels

1. Physical freedom, freedom from limitations, the ability to run or sit comfortably, to pursue the activity that brings you joy. 
2. Emotional freedom, freedom to feel the entire range of human emotion at the appropriate time, without getting stuck in one emotion
3. Mental freedom, the freedom to reason and think clearly, the ability to use logic and complete tasks, to sense reality.

All cases are centered in one of those three levels, with physical being less serious than emotional and emotional less serious than mental. A healthy mind with healthy emotions can have a long, full life in a limited body (e.g., an amputee), but a person who can’t think or remember doesn’t have much of a life even with a body (e.g., late Alzheimer’s). Each level of health effects the others- someone with long term depression likely has low vitamin D, low energy, poor nutrition and mental dullness, someone with asthma probably has some anxiety. 

We are whole people, and each person must be considered and treated at the level of dis-ease that they present at. 

A canadian doctor has taken a fecal microbiota transplantation sample and cultured out 33 strains of bacteria, creating a synthetic human stool to use in cases where fecal microbiota transplant is indicated. The study is due out sometime this year, our professor apparently had an advance copy of the article.

The name of the product: rePOOPulation. 

Commonly affecting children age 1-4, it typically causes Hand, Foot, and Mouth disease.  In infants, the course of disease typically begins with the refusal of food due to a sore throat. Then they get a mild fever, and then on day 3-5 a skin rash shows up on the hands, feet, and mouth. In the mouth the rash is typically blisters, but on the hands and feet the rash can just be erythematous, small circles. Or it can be blisters there, too.  Super contagious, droplets, fecal matter, all that stuff. 

My kid has it. He’s doing fine.

He gave it to me. I’m dying. I thought I had strep throat at first, as I had 3 of 4 centor’s criteria and my fever hit 103.4 a couple times. Today the rest of the rash showed up on my hands and feet. I only have blisters all over my mouth and throat, the rest of the rash is macular. Some of the blisters in my throat are approaching a centimeter in diameter. Kiddos rash is all vesicular.

Moral of the story:
Childhood illnesses are always best kept in childhood

Also:
Children are slimy little adorable plague bearers.

I keep getting flamed in small discussion groups for sending hypothetical patients for surgery or drugs. Here’s the deal:

Naturopathic medicine is great. Yes, we totally have alternatives for most things. Yes, you could do homeopathy instead of surgery for appendicitis, but there’s no way in hell that skipping the surgical consult is in the best interests of the patient. There’s a reason for the algorithm. There’s a reason for the therapeutic order. That’s the reason the clinic protocol starts with: Call the ER. 

If your patient has a history of perforated ulcers, has an ulcer right now, and also has a nasty H.Pylori infection that is so bad it was imitating Zollinger-Ellison Syndrome, the risks of perforation outweigh the benefits of using the all natural antimicrobial protocol that takes a month to be effective. The hyperchlorhydria needs to be addressed now, this week. Sure, talk to your patient about how to prevent reinfection. Talk about the lifestyle changes and the diet changes. Give the supportive botanicals, but don’t hold so tightly to your personal ideals for naturopathy that you are refusing to use the tools that are within your formulary.  Perforation complications could kill this patient. Complications could screw up this patient’s pancreas, could screw up their nutrient absorption, could do a number of other things that a doctor has to consider before deciding on a treatment plan. 

There’s no such thing as bad medicine. There’s inappropriately used medicine, bad protocol, bad decisions in medicine, but the medicines themselves are neither good nor bad- they’re just tools.  

teacher discussing the need for a DEA numbers and using cocaine as a topical anesthetics.

This is one of the reasons that I disagree with the current AMA standards of care. Medicine, as an industry, is run by pharmaceutical companies. I’m not saying that pharma is the devil, only that it’s overused and understudied, or studied by people who have direct financial considerations in the outcome or by people who have such a large mental bias that nothing short of a meteor could rock them into doing an appropriate study. 

My gastro teacher was talking today about a patient of his who came in on prilosec “Because she had a vitamin P deficiency. Everyone who goes to a gastroenterologist finds out that they have a vitamin P deficiency.” 

58% of americans experience GERD on at least an occasional basis, most of those on a weekly or daily basis. Are they all prilosec deficient? 

It seems to me that it’s more likely that most of these are patients who eat mostly processed foods and refined carbs, who have chocolate, cigarettes and caffeine while they drink their soda and their peppermint tea. They’re stressed out and eating drive through food in their cars because they have a second job to make ends meet, or they couldn’t afford vegetables, or they were never taught how to make nutritious food. Does this stress really need vitamin P?  Wouldn’t a cultural shift towards healthier, slower eating and living habits be a cheaper and more effective treatment?

We medicate lifestyle choices and we medicate emotions. We palliate, sedate, stimulate, and generally try to live our lives in this narrow grey corridor where we’re just like the neighbors that we don’t know or talk to. We do it because the studies tell us to, and they pay us more to give that one.

Lord keep us from ever discovering G-23 paxilon hydrochlorate.

(via koumeps)

jackieandpercy:

they love to talk to you like you are the dumbest motherfucker in the universe. i wonder if they talk to rich people that way. (the bad ones. i know not all doctors are like that, thank gob.)

waited two hours to see this textbook asshat who didn’t tell us anything about the procedure we didn’t…

Another great example of why bedside manner is important. I’m not kidding when I say I went into medicine because I and family members had terrible doctors. Stories like this aren’t hard to find, as cranquis pointed out with his referal post. (On my phone, can’t link, will edit in later) Medicine is largely still a system in which you need to know the right people or get lucky to get good care, and it shouldn’t be that way. I wish there was a social imperative to go into medicine for the taking-care-of-people aspect, and less of that prestige, power, and perceived money impetus.

Had some serious stuff go down on le facebook today. One of the people I went to highschool with (but am not friends with, so I only chanced to see this because of lax privacy settings) posted this: “I feel like I’m going to die of depression…”

Which, holy Whoa. 

Friends jumped on with the “We’re here, call us” and the “don’t spend all your time in the house cards” but I just wanted to put out some resources for anyone else who finds themselves in the same boat. Depression affects an estimated 1 in 10 adults (including me, by the way. I’m currently in a therapy program again for postpartum depression, but I’ve had regular ole depression too.) Signs of depression include:

• Feelings of hopelessness and/or pessimism
• Feelings of guilt, worthlessness, and/or helplessness
• Irritability, restlessness
• Loss of interest in activities or hobbies once pleasurable
• Fatigue and decreased energy
• Difficulty concentrating, remembering details, and making decisions
• Insomnia, early-morning wakefulness, or excessive sleeping
• Overeating, or appetite loss
• Thoughts of suicide, suicide attempts
• Persistent aches or pains, headaches, cramps, or digestive problems that do not get better, even with treatment

Depression is a medical problem, and it’s not something most people “just get over.”  Anti-depressants, psychotherapy, in-patient treatment, or any combination of the those things may be needed. Antidepressants need about 4-6 weeks to work, which is good to keep in mind when things don’t get better immediately. 

If you’re depressed, and you’re thinking about killing yourself, don’t. Call 911 instead, or go to the local emergency room. Call your health practitioner. Call the national suicide prevention hotline at 1-800-273-8255, or internet chat with their counselors at http://www.suicidepreventionlifeline.org/

If you’re not in immediate crisis, still get help. Call your health practitioner, google the free mental health clinics- they exist and are there to help you-, just start. There’s a useful helpguide here. Just do what you can, get a small start. Stay focused. 

Get help. 

We’re all human, aren’t we? Every human life is worth the same, and worth saving.
-JK Rowling

Just hang on, hang on to the vine
Stay on, soon you’ll be divine
If you start to cry, look up to the sky
Something’s coming up ahead
to turn your tears to dew instead
-Pink Martini 

I added the midwifery certificate classes to my schedule for the next three years today. I’ve been on the fence about this for two years, but I’ve really fallen in love with the first (required for everyone) class. I’m still on the fence a little bit, but I’d rather have the classes and be able to take the NORM exam (for CPMs) than wish I’d added the classes the whole time and have to go back for 2+ years after I get my ND.

Hurray for jumping off and taking risks!