HIATUS

Hello dear readers,

I've decided to take a blogging hiatus. Clinic has been quite demanding (in a good way! I'm learning lots!) and thus I've been spending my downtime far away from my computer. I haven't had the energy to blog nor the enthusiasm (when you spend your days talking about health and wellness, it makes evening chats about the same topics a tad more difficult). I do still love blogging, but lately I haven't been inspired... So I am taking a break until I get my blogging groove back. 

Thanks for reading for all these years and for understanding the current situation. Until I write to you again, enjoy your Summer!

--- The Navigator

Treatment Tuesday 1: I'm in clinic!

I've been in clinic for almost two weeks now and boy-oh-boy has it been exciting! So far, so good. I'm am loving my supervisors, shifts, schedule, office, and all that jazz.

I am shocked at how easy the transition from student to intern would be. Upper years told me that you'd be "very uncomfortable" for AT LEAST a month. But surprisingly, I haven't been nervous! I've actually felt very comfortable in my new role. I guess that means that I'm in the right profession :)

So what have I done so far... had a shift in the Botanical Compounding Room (see below), had a full day of orientation/training for the Adjunctive Cancer Care shift, started at a satellite clinic, performed acupuncture, and even given some vitamin B12 injections. It's been a very busy, but very exciting couple of weeks.

Look at all those tinctures (back wall)! To the right are loose leaf herbs that can be used for teas!

Medical Monday 1: Mind and Mood

Today we're chatting about mind and mood.

Lately, I've received lots of questions about mind and mood, and what are some things that could be done to improve it naturopathically. This obviously isn't an exhaustive list and you should of course consult your own naturopathic doctor or health care provider to discuss an individual treatment plan, but here are a five mind and mood 'boosters'. 

1) Dietary Additions, like egg yolks. According to this article, titled "Eat Your Egg Yolks", the choline found in egg yolks helps healthy brain development (so eggs are very beneficial for pregnant moms). There are many other foods that help the mind and mood. Talk to your healthcare provider, dietitian, or naturopathic intern (find one here!) for more dietary support. 

2) Mood Gym. This website features exercises to help people who experience anxiety and depression. It's free, but you have to sign-up/create an account to start using the exercises. 

How about a life-size game of chess to boost your mind?

3) Mindfulness. Interested in learning more about mindfulness? I learned about mindfulness in school, but also with the help of this book.

4) Fatty Acids. The standard north american diet is heavy in omega 6 fatty acids and low in omega 3 fatty acids. The healthy ratio of omega 6 to omega 3 should be about 2:1, but research says the ratio is now more like 15:1. Yikes! Thankfully omega 3s are found in some yummy foods, like fish, walnuts, flaxseeds, and even grass-fed beef.

Salmon has omega 3 fatty acids

5) Herbal Support. This Summer, second-year students will be writing NPLEx 1 and new graduates will be writing NPLEx 2. In preparation for this major exams, many herbal supplement companies were offering deals to students on herbal mind support. Herbs like Gingko and Bocoba were selling like crazy! There are lots of herbs to help balance mood or boost memory. Talk to your naturopathic intern to find the herb support for you. 

Oopsie Daisy! (Foodie Friday 1)

Whoa, whoa, whoa! Hold the phone! 

What happened to the new blogging schedule starting on Monday, May 20th? Um, yeah. I got side-tracked by all the wonderfulness of being in Clinic! My sincere apologies. 

Let's get back on track today, with the first Foodie Friday blog post!

It's almost 'burger season' (also known as 'Summer')

Looking for some healthy dinner inspiration? Well, I've got five wonderful, Summer-y, and healthier dinner recipes, collected from around the web, to share with you today. 

Happy cooking!

1) Sweet Potato Burgers. It's almost barbecue and burger season. These vegetarian burgers are wonderful when topped with avocado (as suggested in the recipe). Make them gluten-free by using gluten-free instant (or slightly ground rolled oats) instead of panko bread crumbs. 

2) Green Sushi Salad. We've made variations of this wonderful dish in our home many times, but here is a professional recipe with pretty pictures. With this you get sushi, without the fuss of rolling the ingredients up. 

3) Jarred Salads. This would actually make a wonderful lunch, but you could have it for dinner too, especially if you were having a picnic! The key is to keep the dressing at the bottom of the jar to prevent the salad greens/veggies from getting soggy. When it is time to eat, simply shake it up and dig in. 

4) Chopped Kale Salad with Creamy Almond Ginger Dressing. This recipe is wonderful, but the dressing is really where it is at. Make the dressing and pour it over any salad of your liking or pour it on top of baked or steamed vegetables. Oh, and it also makes a great dip for raw vegetables. 

5) Shrimp Mango Tacos. I don't normally eat shrimp, but I love the idea of these lettuce-wrapped 'tacos'. You could alternatively use chickpeas, chicken, or even baked tofu cubes. 

Year 3, Semester 2: Favorite Classes

Now that year 3, semester 2, is over, it's time for a recap! 

Urinalysis dipsticks!

This term, it was all about the little ones. There was a class in Pediatrics and one in Maternal and Newborn Care (two separate classes). I found both of these classes to be super interesting, probably because I know little about pregnancy, new babies, and wee children. I also loved focusing on treatments that were suitable and safe for children and babes. Sure I know the therapeutic dosage of vitamin D for adults, but how do I adjust this dosage for kids, new mothers, and infants?

My third favorite class (if you can consider it a class?) was Clinic 3. This "class" had us in the clinic, working with a fourth-year student, seeing patients, practicing charting, doing physical exams, and working on the treatment plan. It was a great introduction to what will be life come May when I enter the school's clinic full-time. Loved having this "sneak peek".

An honourable mention goes to In Office Procedures. In this class (though it wasn't really a class, more of a tutorial) we learned to draw blood (phlebotomies), inject vitamin B12, test blood glucose levels, and perform skin scrapings, Strep throat swabs, urinalysis, and more. It wan hands-on time to get us comfortable with the in-office procedures that we'll be performing next year and throughout our careers as naturopathic doctors.

My New Home

Formal lectures and classes are officially over! 

Instead of hanging out in the Lecture Theatre all day, this will be my new home come May: the clinic!

 Treatment room of the RSNC (my school's teaching clinic). Rooms feature chairs for chatting, a treatment table (for physical exams, manipulations, acupuncture, massages, and more), and a sink area where basic medical equipment is kept (gloves, swabs, tongue depressors, etc). 

In the conference rooms where we debrief after a shift, a copy of the Naturopathic Doctor's Oath (pictured on the right) hangs to inspire us and keep us on track. 

Brampton Naturopathic Teaching Clinic

On Friday, I visited the Brampton Naturopathic Teaching Clinic. This is a new, second naturopathic teaching clinic located within the Brampton Civic Hospital. I shadowed the three fourth-year students on shift (there are normally six on, but some students were using up the last of their vacation) who were all under the supervision of a naturopathic doctor.

The Brampton Civic Hospital is quite new (built in 2007) and my school has acquired part of the outpatients portion of the hospital, on the third-floor of the main building of the hospital. The naturopathic teaching clinic is huge! Lots and lots of treatment rooms, a reception area, a large intern waiting area, and a massive patient waiting area). There is definitely room to grow (which is the ultimate goal if funding is acquired).

Unfortunately, it is very "hospital" like; so if you don't like hospitals, this isn't the place for you. For instance, there were three "code whites" while I was shadowing (code white means violent patient, FYI). I didn't like the treatment rooms at all; they are very medical-y, complete with icky hospital beds. I also much prefer the comfy chairs in my school's teaching clinic, the RSNC, to the plastic ones in the Brampton Clinic.

But there are plenty of positive aspects to the Brampton Clinic too. It's very busy (it's free for patients, which helps a lot!) and like I said, it is BIG. I'm sure my classmates who will be working there in May (I didn't apply) will really enjoy this new working environment.

If you live in the Brampton area, check out CCNM's second teaching clinic. Follow the link above to learn more!

Vitamin B12 Injections and More

On Monday, I performed my first vitamin B12 injection. 

Vitamin B12 (also known as cobalamin), is a B-vitamin in the body. It is water-soluble, so when the body has enough of this vitamin, it will simply pee out any excess. Overdose or toxicity from vitamin B12 is extremely rare due to its water-solubility. Vitamin B12 can not be synthesized by the human body so it must be consumed. It is found in animal products, so vegetarians (who don't eat a lot of eggs or dairy) and vegans need to supplement B12. Nonetheless, even meat-eaters can be deficient in this vitamin and benefit from supplementation!

Importance: Vitamin B12 is super important for cell metabolism, DNA synthesis, neuron function, and more. If you are deficient in vitamin B12 you may feel fatigued, weak, experience brain fog or poor memory, suffer from constipation, asthma attacks (in asthmatics), have a sore tongue or canker sores, and/or decreased (numbness) or increased body sensations (tremors or tingling).

Supplementation Means: If you are supplementing, aim for sub-lingual tablets (i.e. pills that you place under the tongue until dissolved) or vitamin B12 injections. These two supplementation forms ensure that vitamin B12 is well-absorbed by the body because they enter the blood stream more efficiently than swallowing a tablet that needs to go through the entire digestive tract before it is absorbed.

Injections: Naturopathic doctors can provide vitamin B12 injections. They are very expensive and minimally painful. You simply get an injection into the deltoid muscle on the shoulder (that big muscle on the side of the shoulder). Some people get injections weekly, biweekly, monthly, or on a as-needed basis depending on their needs. Most people feel a sudden surge of energy after receiving an injection! Vitamin B12 is the energy vitamin, so this makes sense.

Who should supplement with B12? People with pernicious anemia (an autoimmune disorder) need regular vitamin B12 supplementation as they are lacking intrinsic factor, a molecule that helps with B12 absorption. Vegans and vegetarians need to supplement. People with asthma may benefit greatly. And of course those who through a medical intake, present with the symptoms of B12 deficiency. Simple blood work can also detect low levels. The elderly may also benefit.

Parting Words: Talk to your healthcare provider if you are concerned about your vitamin B12 levels. Also of note, vitamin B12 is a beautiful, bright red color, so the fluid injected into the muscle and the tablets you take sub-lingual, should be both red. Don't worry, there aren't any dyes or artificial colors; that gorgeous color is all natural!

Life Updates

- I have roughly one month left of classes until I enter clinic! It's going to be the last month I set foot in a classroom in my life... after twenty years of classes. Crazy.
- I start learning vitamin B12 injections tomorrow.
- I've made this pizza twice now. Awesome!
- I have my official clinic schedule for next year! I'm super happy with the shifts I have AND the supervisors who I'll be working under. I'll talk more about my shifts, satellites, and supervisors in a later post.
- I had my OSCE 3 on Friday. Here is how it runs: enter clinic room, greet patient, take their history (i.e. ask them a ton of questions about their health complaint), rule out emergent conditions and red flags, perform physical exams, diagnose the patient, recommend further testing/labs, and recommend a treatment for their condition ...all in 18 minutes ...all the while being marked/evaluated by a clinic supervisor who is sitting in the corner of the room ...then repeat this whole process two more times with two new patients. It was an adrenalin-packed hour that's for sure!
- I celebrated completed OSCE 3 by checking out this place with friends. Fun times.
- I think my OSCE 3 went very well. I was proud of performance(s). I have to pass OSCE 3 in order to enter clinic. Here's hoping the evaluators thought I was competent!

Caramel Apple Timbits

- I made these donuts yesterday (but since I didn't have a donut pan, I made "timbits" using a mini muffin tin).  They are pictured above.
- Anyone have nice Spring weather yet? While it's sunny out here, it is still cold.
- I walked into Bulk Barn this weekend: holy Easter candy overload! I forgot how sugar-laden this holiday is. However, seeing them all (an entire row of Eater candy only, by the way) brought make nostalgic memories. Malt chocolate eggs, foil wrapped chocolate eggs, jelly beans, gummy bunnies, mini eggs, caramel filled chocolate eggs... Om nom nom!
- I selected my clinic office for next year. I'm going to be sharing a room with two of my CCNM best buds. 

Daffodils in My Future

There are daffodils in my future... 

The daffodil is the symbol of the Canadian Cancer Society

...and my future holds a lot of time with this book: 

Naturopathic Oncology by Dr. Neil McKinney, ND

As my class' (CCNM class of 2014) fourth-year clinic schedule will be published on Monday, I think it is an appropriate time to announce that next year I will be treating cancer patients at my school's Adjunctive Cancer Care Clinic Shift located in the RSNC teaching clinic.

Way back in January, I submitted my essay and resume to the selection committee, and was shortly after short-listed for an interview. I was then interviewed by the supervisors of this shift (who are naturopathic oncologists). Then, about 2-3 weeks after that, I was notified that I was selected to partake on the Cancer Care Focus Shift. Hooray!

What an opportunity! I am so happy to be partaking in this shift next year and I can't wait to learn from these experienced NDs who've been working with cancer patients for years. I definitely plan to offer naturopathic cancer care to patients in my future clinic and with this shift under my belt, I am well on my way to learning the cancer-care ropes!  

New Classes!

So what's new for year three, semester two? Here is a brief overview of my new classes:

This is supposed to be a stack of books. lol

Integrative Therapeutics: this is basically this is my "treatment" class. We discuss the main naturopathic treatments for the most common health concerns. Lots of research reviewing in this class. Who says that naturopathic doctors don't use evidence-based medicine (EBM)? So not true!

In Office Procedures (IOP): minor medical procedures are taught in this class. Like blood draws (phlebotomy), vitamin B12 injections, administering intravenous (IV) therapy, minor skin surgery, etc.

Pediatrics: the class all about treating patients aged newborn to teenager.

Manipulation: we learn to manipulate the spine and other bones in the body to re-position realign bones in the body use hands thrusting techniques.

Maternal and Newborn Care: the class all about pregnancy, birth, and the first year of life.

Emergency Medicine: how to handle emergencies as a health care provider. Everything from fainting to head trauma to tackling major skin wounds.

Clinic 3: I am now in the school's teaching clinic (the RSNC) for one shift a week! This program/class is designed to help bridge the gap between classroom studies and our full-time clinical rotation that begins in May.

Semester Books

My Year 3, Semester 1 Notebook. 

Another semester about to wrap up, which means that I've completed yet another semester book.

What is a year book? When I started at CCNM in the Fall of 2010, I found myself learning so many cool things that I needed a place to document them all! Plus, my mind was racing at the start of CCNM and I find journaling (and blogging!) to be very therapeutic; I'm the type of person why needs to write things down. I wanted something small enough that I could carry it with me too (I don't always bring my laptop to class). I decided to start bringing a little notebook around with me where I could jot down these important notes because some things are just too important to be lost in the kerfuffle of course notes.

What I have included in these books over the past 3ish years: funny things profs said or did, blog post ideas, to-do lists, goals, memories, inspiring quotes, fun facts, reminders for fourth year, and future practice ideas. Many of my interesting tid-bits were taken straight from these notebooks!

Don't forget that ACE-inhibitor drugs cause coughs... purchase a tabletop dishwasher for tea mugs in my future clinic... recommend the book The Easy Way to Quit Smoking by Alan Carr to patients who want to quit smoking... talk about orange peels on the blog... 

...these are a few examples of things that are written down daily in my semester-long notebooks (I thought I would have one book per year, but I guess there are too many cool things to document during my time at CCNM that I ended up needing a new book every semester. The book featured above has two unfilled pages left and there is only one week left of classes: what perfect timing!

Now when it comes to time to look back at my time at CCNM, not only do I have this blog, but I'll have eight little notebooks to remind me of what was important, inspiring, blog-worthy, and so on.  I am especially grateful that I kept a running list of "future practice ideas" because almost daily something comes up that is important but I know that I'll forget about if it doesn't get written down. I also don't want to have to rummage through thousands and thousands of course notes to remember what is the best supplement brand of 5-HTP (a mood enhancing supplement), for instance. Hopefully I've kept the best notes in these little books, which means I'll only have to read eight little books instead of potentially hundreds in order to find out that brand (which is Natural Factors, by the way).

Play With Your Food

I recently bought this adorable plush fruit basket to keep in my future office waiting room for children/babies to play with. I had been eyeing one for myself ever since I bought two of my mommy friends' children each baskets. I think it is a good waiting room/office toy because I can easily throw it in the wash when it is looking grubby and because it can encourages healthy eating (subliminally) at a young age! Or is it bad because it encourages kids to 'play with their food'? Hmm...

Year 3, Semester 1, Class Review, Part 1.

It's about time that I reviewed my Year 3, Semester 1, classes! This is part 1 (five classes today, five classes tomorrow). Here we go:

Botanical Medicine 3 - Same old, same old. We're learning about 250 herbs this semester (yikes!) in the same we we've always learned about herbs (by reading monographs).  It's pretty boring.  On Wednesdays, however (we have the class twice a week), we do cases and come up with herbal formulas.  I quite like the cases because they seem so REAL. In less than a year I'll be coming up with herbal formulas for a whole variety of health concerns, so these case exercises seem really practical. (Oh, but I will soon HATE Bot Med 3 because apparently the midterm is brutal...).

Primary Care - Also known as, 'let's play doctor' class!  I find this class fascinating. We take turns being doctor, by interviewing a patient, and then performing the relevant physical exams.  Then as a group we have to diagnose the patient, do research on the diagnosis and treatment options, then write-up a full treatment plan. It's a lot of work, but fun work! This, like the Bot Med cases, is also very practical.

Men's and Women's Health - I may never meet a patient in my life who has a Chronic Bronchitis or who has Generalized Anxiety Disorder (i.e. specific conditions), but I most definitely WILL meet a male and a female patient :P  The point I am trying to make: this class is very applicable! Everyone in the class will benefit at least from 50% of the class teachings in regards to their own personal health. We have to do a research paper in this class too and my topic is a good one, so it's been enjoyable to work on.

Health Psychology 3 - We got shafted in our first and second year psychology classes. Seriously: I want my money back!  What a joke... Anywho, I am finally learning this year!  We have new-to-the-school professors and we're learning about relevant stuff, like how to assess someone with a mental disorder and the diagnostic criteria for all kinds of mental disturbances (e.g. Major Depression, Panic Attacks, Obsessive Compulsive Disorder, etc).

Practice Management - Also known as business class.  Lots of number crunching and market discussions. We have a lot of guest speakers in this class too, which keeps things interesting. We have a big group project in this class that requires us to create a full business plan, which is excellent practice for when we have to make a real business plan in a very short period of time!

Third year is shaping up to be very, very different from my second-year experience.  Second-year was very depressing (pathology, microbiology, disease, etc, etc) as we learned how to diagnose, but this year is so-far quite uplifting as we learn how to treat! We're finally learning how to make people feel better and that is a wonderful feeling.  As of right now, I'm loving school again, including all of the silly assignments and group work that comes with third-year, because it's all making me very feel very excited for the real world which is just around the corner!  Day-after-day, and little-by-little, I'm feeling more like a doctor-to-be :)

Exciting Things at CCNM.

Image source here.

Exciting things are happening at CCNM these days!  Here's a quick summary of some of the latest CCNM news:

- CCNM is going to open the first teaching clinic in a hospital in North America! The clinic will open in Winter of 2013 and will feature general naturopathic medicine shifts. That means I might be able to intern there during my fourth year of studies!

- In addition to the Sports Medicine, Cancer, and Pediatrics specialty shifts offered in the school's teaching clinic, two new shifts have been added: a fibromyalgia/chronic fatigue shift and LGBT/immigrant community-focused shift.

- Concerns with the preceptorship program (I've complained about this program before on the blog) are finally being addressed. In the word's of CCNM's dean "Students feel that a large number of NDs either rejected or ignored their request to precept with them" Yep, this has happened to me many times. As a result, the school is reducing the number of hours required (we did need 100 hours, which is simply too much).

- CCNM surveyed students who wrote NPLEX on August 7, 2012. The survey results found (according to the school's dean): "...that while certain areas of the NPLEX exams had improved, the exams were still testing minutia, that NPLEX I was not considered a fair assessment of biomedical knowledge and, most importantly, that there was a disconnect between what was being taught at CCNM and what was being tested". Agreed (I complained about these things already on the blog)!  Thankfully, NABNE---NPLEX's governing body---is looking into CCNM's concerns. Let's hope that the exam will be better for the second-year students who will have to write it this upcoming Summer.

Classes, Part Three.

Yesterday, I had to register for my third-year classes.  (Wait, let's back up a sec: YEAR THREE, PEOPLE! Seriously, how exciting is that?!).

The process was unnecessarily painful (arg, CCNM! why must you be so frustrating?!) but thankfully it's done and done.  Here's the low down:  

Fall Semester - No choice here. Just had to register into all of the third-year courses (because I am a full-time student, I just enrolled myself into anything marked year three). Looks like it's going to be very, very similar to second-year.  Same classroom (the lecture theatre), same hours (roughly 8-4 or 9-5 PM each day, save for Fridays (off a wee bit earlier on this day, wahoo!)), and same amount of practicals (about three (?)).

• Botanical Medicine 3 (going to be the worst.course.ever., or so the upper years have said)
• Men's & Women's Health
• Health Psychology 3
• Primary Care (not sure what this course is about? Sounds serious)
• Radiology & Advanced Imaging (X-rays!)
• Practice Management (business, etc)
• Physical Medicine (not sure what this is about either, but apparently it is hard)
• Clinical Nutrition 3 (my favorite!)
• Asian Medicine 3 (theory)
• Asian Medicine Clinical Applications (acupuncture practicals)
• Homeopathic Medicine 3

Winter Semester - The only choice here was our clinic shift (one day a week) and when we wanted our acupuncture and manipulation practicals. This choice, however, was very stressful and caused a lot of panic amongst the class.  Sheesh we're a high-strung group of students! Haha. 

• Continuation of Primary Care, Asian Medicine, and Homeopathy courses, plus...
• Naturopathic Manipulation 2
• Pediatrics (babies!)
• Maternal and Newborn Care (more babies!)
• Integrated Therapeutics (no idea what this is)
• Clinic 3 (one shift a week in the clinic, shadowing a fourth-year)
• In-Office Procedures
• Emergency Medicine

I am not really worried about the Fall term, but to say that I am nervous for third-year, Winter semester is a huge understatement.  I am pretty sure those four months are going to be some of the most stressful ones in my life.  Third-year, semester two, is known is a "soul crushing" time (real testimony).  There is no mercy during those months: thirteen final exams, ~twenty essays, performing female and male genital exams (on REAL people), OSCE part 3 (the hardest one), performing spinal adjustments (!!!), performing FULL acupuncture treatments, spending real time in the clinic (it'll be scary being in there FOR REAL), etc, etc. *Starts hyperventilating*.

Well, there is no looking back now... 'cause as of yesterday, I'm all registered :D.  Just got to motor-on-through and GET 'ER DONE!

Smoked.

When it comes to our health, I think we can all agree that cigarette smoking is bad for it. There has been lots of research to prove that cigarettes are carcinogens (i.e. cancer causing agents).

But now other, newer research is showing is that other smokes can also harm our health. Examples include:

Campfires

Candles

Smoked meats 

Smoked salmon

Smoked paprika

BBQs (inhaling the fumes) 

Sad, but most likely true, that our beloved birthday candles, campfires, and smokey meats, are all harmful.  Believe me: I am quite depressed by the above list as well. I absolutely love smoked paprika (a key ingredient in my fakin' bacon recipe) and since I only started eating fish last year, I've only had smoked salmon a handful of times in my life---and let me tell you---I definitely miss this savory treat.

But, with everything in life, moderation is what is key.  We only have one birthday a year, so have fun blowing out the darn carcinogenic candles!  Hanging around one or two campfires this Summer should be a-O.K. too. 

However, I would really like to encourage regular BBQ-ers to be careful and to avoid breathing in the fumes.  And as for my meat-loving readers, please be a little more wary of the smoked varieties.

The Diet Diary.

A diet diary is a tool naturopathic doctors use to take a peak at their patients' daily eating adventures.  Patients are asked to record everything they ate and drank each day, for a week. 

This is somewhat similar to the one they use at CCNM.  Found here.

Pros (of Diet Diaries):

- gets patients thinking about their diet and where their daily calories are coming from
- encourages patients to eat proper meals (because the chart is divided into breakfast, lunch, and dinner, with a spot for snacks on the side)
- allows the ND to help the patient to eat better. The diary is not something that the ND will critique, but will use as a template to make minor improvements (maybe more protein in the morning, fewer carbohydrates in this meal)
- helps address nutrient needs and/or deficiencies. The ND will be able to see if the patient is getting enough protein, fiber, vitamin C, calcium, etc, by analyzing the week's diary.
- help address water intake (a biggie; most people aren't drinking enough or don't really think about their water intake. The diary will make the patient start recording and thus thinking about H2O).
- typically, there is a spot for 'symptoms' too; meaning, if a patient eats pineapple and then has an afternoon stomach ache, or ate whole wheat toast and then felt bloated, then the doctor can begin to hypothesize some potential food sensitivities. The diary can be a starting point; sparking ideas for further health explorations.

Cons (of Diet Diaries), Part One:

- patients are consciously aware of their food being 'monitored'; they may skew their eating to 'please' their ND or may leave some things off the chart entirely. It is important to be honest with the diary and eat 'normal' during the recorded week.
- portions are often not recorded, maybe because the patient doesn't know much about portions. For example, the chart may read "spaghetti and meatballs" for dinner, but how much pasta was that? A handful or a salad bowl full? What about the meatballs? Was that 4 or 10?
- it's only a week. A week is really just a peak at a person's diet.  It's certainly better than nothing, but a month of diet recording would be ideal.

Cons (of Diet Diaries), Part Two:
(These are the things I hope to change on the diet diaries I hand-out when I am a practicing ND)

- an exercise log. What if a patient ate a salad bowl full of pasta (which seems like a lot!) but then ran 15 kilometers the next day? Or what if the patient had only salad for dinner, after the spent two hours at the gym? It is important to track activity in addition to intake to find out whether or not the patient getting enough fuel.
- a section for all drinks (coffee, pop, juice, wine, beer, herbal tea, etc, all contribute to one's diet and should be accounted for in the diary).
- number of bowel movements per day.  Some foods can promote constipation, while others make bowel movements more diarrhea-like (especially common food sensitivities, like dairy or gluten).  Bowel movements (as yucky as this sounds) is an important piece of the diet puzzle too.
- supplements should be tracked too.  Is the patient taking fish oil? Protein powder? Calcium chews?
- emotional feeling. In addition to physical symptoms (bloated, tired, headache, skin broke-out, etc) emotions should be recorded too.  Food can definitely stir-up our emotions. Did any foods make you feel satisfied, depleted, giddy, or miserable?

CPR Tid-Bits.

This morning I was in class for CPR (cardiopulmonary resuscitation) training.   As a (future) health care practitioner, I have to make sure my CPR training is up-to-date (by renewing it every one-to-two years). Hence the need for this morning's class!

Image source here.

Here are a few interesting tid-bits from the class:

- Most people are afraid to administer CPR to someone who needs it, because they are afraid that they may 'hurt' the person. CPR is given when the heart stops pumping, and when the heart stops pumping, a person is clinically dead. As the instructor put it today, how much could you possibly hurt to a person who is clinically dead? 
- With the above said, you are likely to break some ribs when performing CPR, but again, a couple of broken (and very heal-able) ribs is nothing compared to death!
- If you administer CPR (in Canada) and you perform it in good faith, you are protected by the Good Samaritan Act.
- Someone who needs CPR (i.e. his or her heart has stopped) is considered clinically dead, but is still biologically alive because the brain is still alive (and it can stay alive for up to ten minutes after the heart has stopped).
- In old CPR courses, instructors had to teach students about payphone locations in order to make the 911 call! Nowadays, cell phones are everywhere (if you don't have a phone, chances are that the person you are helping has one in their purse or pocket).
- An important note about cell phones: even if they are 'locked' or need a password to use, they all have a 911-overide option, meaning that you can still dial 911 on a locked/protected cell phone.
- The goal of CPR is to mimic the heart.  The chest compressions preformed mimic the beating of the heart, moving blood around the body (especially to the brain!).

Preceptoring Woes.

Yesterday, I had the wonderful opportunity to preceptor with a lovely Naturopathic Doctor in her equally lovely clinic.

What is preceptoring? It's basically job-shadowing; a student sits in the corner of the clinic/treatment room, acting as a fly-on-the-wall, not saying a word, just observing the doctor-patient interaction.

While I absolutely love hanging out in clinics, taking mental notes of treatment options, and watching the 'magic' of my profession unfold, I hate preceptoring! 

Now why on Earth would I hate preceptoring? Given the sentence written above, it sounds like I enjoy most aspects of the experience. But what I don't like---and thus makes me dislike preceptoring all together---is burdening Naturopathic Doctors and their patients.

First, the office of an ND is a very therapeutic space.  A space in which confidential information may be shared, uncomfortable physical exams may be preformed, needles may be inserted, and one in which deep emotional healing may finally occur. Every appointment is an opportunity for healing and growth, and thus I hate, hate, hate that I have to intrude!  Treat the individual is a naturopathic principle, yet I feel like patients are not given the space they need when there is a student lurking in the room.

Second, naturopathic doctors are busy, busy people. Their days are packed and there is little room to entertain a student for a day (or more!).

What's more? CCNM students need 100 hours of preceptoring hours before convocation! That's a lot of days spent stalking naturopathic doctors (and other health professionals) and their willing patients :P  One-hundred hours is over two weeks of full-time (8 hours per day) days spent in clinics.  As since most NDs accept students to come in for a day (or two), that means that it is possible to shadow over ten different practitioners to get the hours logged. Yes, it would be wonderful to see the clinics and techniques of ten different practitioners, but in city of Toronto, good luck finding ten willing healthcare providers to take you on (even for one day).

Thankfully, CCNM is looking into this steep requirement and (hopefully) based on student input, is going to change the policy.  Unfortunately, if the policy is changed, it will likely not affect me, but future CCNM students. Nonetheless, I definitely think that there is a problem with current preceptoring requirements and will be happy when some changes are made.

Alright, enough ranting.  See you tomorrow with something more up-beat :)