Salty Suds

Epsom salts (which aren't actually salt but minerals, specifically magnesium sulfate) are salts that when added to bath water. They help relax, physically and mentally, by relaxing both the mind and muscles (see below for a more thorough explanation). The use of Epsom salts originated from observing the use natural mineral baths or soaking in hot springs to treat conditions in Europe.

Directions: Simply add a 1 cup (or 2) of the salts to a warm bath. Those with high blood pressure or those taking blood thinning medications should talk to their doctor before initiating this treatment.

Mental Effects: The body's magnesium levels get depleted during stress, causing fatigue both mentally and physically. When the salts are dissolved in the bath water, they are absorbed through the skin. When absorbed, they increased the level of magnesium in the body. Magnesium is a cofactor in the enzymatic reaction that produces serotonin. Serotonin is a bodily chemical that helps regulate our mood and improves overall energy.

Physical Effects: Magnesium is a known muscle relaxant. When absorbed into the skin from the bath water, the magnesium relaxes the muscles, making Epsom salt baths great for menstrual cramps, sports injuries, body pain, upper body muscle tension, and even constipation (especially if the constipation is linked to stress and an inability to "let go").

I was at Dollarama last month and saw them on the shelf for $1! So they are an extremely cheap treatment option. The one at Dollarama something looked like this:

Source here. 

Around the time that I saw these cheap (and effective!) salts at the dollar-store, was also when I had a disagreement with a teaching assistant (TA) over the cost effectiveness of naturopathic medicine.

I had said "Naturopathic Medicine is very cost effective" and the TA thought this was false. I still disagree. While some naturopathic treatments can yes be very costly and while seeing an ND ($100-150 for the initial visit, $80-100 for follow-up visits) is pricey, a good ND should be following the doctor as teacher principle: teaching the patient ways to take care of their health without relying in their ND for every ache and pain for the rest of their life. There are many, many frugal and sustainable health tips that a doctor can teach a patient during the first few visits that the patient can use throughout the rest of their life. Take my Naturopathic Pantry post for instance. Once a patient has been educated and guided by their doctor about simple and cheap home remedies, and aside from follow-up appointments with the ND, naturopathic medicine should be very cost effective as it relies heavily on lifestyle changes, and using items straight from nature to heal.

Next year, students will complete rotations in clinics that serve low-income and even homeless individuals. If we are able to help these patients, then cost-effective treatment strategies must exist!

Anywho, just my thoughts now. I'm curious to see how my outlook on the cost-effectiveness of my profession may change as I enter clinic starting in May!

Myotomes & Dermatomes

In preparation for my Physical Medicine practical exam next week, I've been practicing locating myotomes and dermatomes, and testing deep tendon reflexes (using Tony as a guinea pig; you will be happy to know that all of his myotomes, dermatomes, and reflexes are intact and functional).

Myotomes are muscles that are innervated by one nerve root of the spinal cord. We test myotomes to look for any signs of weakness in a group of muscles. If a particular group of muscles is weak, then it is likely that the spinal nerve responsible for innervating these muscles may be damaged. Spinal nerves may be damaged by trauma, spinal cord lesions/tumors, or by disc herniation. For example, if you have trouble flexing your elbow, but you can extend your wrist with no problems, then it is not a cranial nerve 6 problem, but a more local problem involving the elbow flexors. If it had been a spinal/cranial nerve problem, then when the cranial nerve 6 myotome was tested (by resisting elbow flexion and wrist extension (with the actions being resisted at the same time)), then both actions would have been weak. Still confusing? Yeah, it's hard to explain myotomes in a blog post... am I am realizing this now when I've almost completed writing this post. Doh!  Anyway, you can watch how mytomes are tested by watching this video posted here. It's a bit lengthy, but it's great for someone who needs to know how to test myotomes like me ;)

Dermatomes are areas of skin that are innervated by one nerve root of the spinal cord. While myotomes are test the motor functioning of a nerve, dermatomes test the sensory functioning. For instance, if you can't feel any sensation on your thumb but you can feel sensation on your index finger, than your cranial nerve 6 dermatome is still intact and healthy. Both areas would be affected if it were a spinal/cranial nerve problem. The lack of feeling in the thumb is likely due to a local cutaneous nerve injury and not due to a spinal cord/disc/nerve root problem. You can view the dermatomes in this pretty, visual video posted here. I love learning about dermatomes because all of the teaching material for them are so colorful!

Lastly, while searching for the videos linked above to help me better understand myotomes and dermatomes, I came across this creative dance video. Through the medium of dance, the girls in the video demonstrate the testing of both myotomes and dermatomes. You can view their dance here. Now, if only I could dance my way through my upcoming Physical Medicine exam...

Carpal Tunnel Syndrome 101

Carpal Tunnel Syndrome is one of the most frequently self-diagnosed syndromes (thanks to Doctor Google :P). As my prof described yesterday, it seems as if anytime people experience a problem in their hand or wrist, they are having a 'carpal tunnel syndrome' flare-up.  However, yesterday, in my Physical Medicine class, we talked all about this syndrome and what is specifically is required in order for a patient to truly be diagnosed with this condition.

The white horizontal band is the ligament causing carpal tunnel syndrome. Image from Wikipedia; originally from Netter. 

Definition: carpal tunnel syndrome is a compressive neuropathy (meaning a compressed nerve), in which the median nerve is squished by a ligament in the wrist (specifically by the transverse carpal ligament, aka the flexor retinanculum, shown above). Nine tendons and one nerve (the median) pass through this ligament. It often occurs during repetitive gripping, like in those who garden extensively, operate hand tools, knit or sew for a living, hairdressers, and computer users (aka everyone)... to name a few examples only.

Symptoms: When the median nerve is squished, the palm of the hand, the fingernails, the thumb, and index, middle, and half of the ring fingers, will feel numb, weak, tingly, and possibly pain. Only these regions of the hand will be affected as these are the areas innervated by the median nerve (see the image below, they are highlighted in red).

Median nerve innervation in the hand. Image source here.

Treatment: Naturopathically, we would prescribe lots of rest (less texting!), wrist supports, hand massages, hydrotherapy (ice during an acute attack, heat other times, or whatever feels best to the individual patient), and anti-inflammatory herbs. People with chronic carpal tunnel surgery may opt for surgery; however sometimes the surgery doesn't help and some people get better without any surgery at all. The surgery involves cutting the transverse carpal ligament to allow it to expand, reducing the compression/squishing of the median nerve.

Note: please seek out professional and individual health care advice. This blog post is not meant to diagnose or treat.

Third Time's a Charm?

I'm currently completing my third-year midterms.  Wait, didn't this semester just start?  How are we at the midterm mark already?!  Oh wait, I know why: assignments. We've all been so busy completing assignments that this semester is flying by (thank you weekly Post Encounter Probes (PEPs), Homeopathy case reports, Men's & Women's Health research paper, Radiology presentation, Health Psychology portfolio, etc).

So here we are, in midterm week, year three.  You'd think that they'd be easy by now (third time's a charm, right?), but nope, they are still tricky and require lots of studying.  Oh well, I really can't complain because there is only one more to go, this week, and then only one more midterm exam period to complete ever (February, 2013)!

Midterms, Year 3, Snapshot 1: On Monday, after our brutal Botanical Medicine exam, our student government treated students to gluten-free, dairy-free, oatmeal cookies for a nice moral boost. Super yum!

Midterms, Year 3, Snapshot 2: Physical Medicine studying last night, complete with chamomile tea! I learned a bunch of exercise-like to test to determine if the patient has nerve impingement or injury, ligament and tendon tears, facet joint pathologies, or nerve tumors (neuromas), to name a few.  I learned a lot studying this material; it was actually---dare I say it---really fun to study Phys Med!

Friction Rubbing.

Sometimes, when we injury a muscle, tendon, or a ligament, we can develop scar tissue around the injured structure.  When this soft tissue lesion heals, rough collagen is built-up; this build-up is known as an adhesion.  Adhesions are not a good development because they can impinge nerves, restrict muscle movement, and cause pain upon movement. In my Physical Medicine class, we learned how to 'break-up' adhesions as they develop after an injury. The technique we learned about is called Cross Fiber Friction Rubbing. 

How it works:
Friction rubbing reduces the bothersome adhesions from building-up, causing the body to form strong scar tissue instead. More specifically, the rubbing reduces the 'roughness' that forms with adhesions, making the resulting scar tissue smoother.

What is done:
A deep, non-sliding, pressured stroke is applied to the injury site (note: not during the acute stage of the injury, but in the sub-acute stage, such as several days after the initial injury). The movement is along the direction of the muscle fibers. . No oil is used topically and the 'stroke' doesn't slide; the skin doesn't move as the muscle is moved.  The doctor applies the stroke using their thumb and it is applied at right angles to the muscle fibers.

Results:
You've been warned! The treatment is quite painful, but it still safe and 'worth the pain'. No pain, no gain! The first treatment will be short, a couple of minutes only, then a day of rest, then another treatment. After a total of roughly 5 treatments, the adhesions will be fully broken-up, and thus the muscle/tendon/ligament will be back to its normal functioning state and will very likely be pain-free.

Follow-up: 
The RICE protocol is indicated (rest, ice, compression, elevation). Lots of ice in particular.

B12 for Asthma?

Vitamin B12

Today in Physical Medicine, we learned that injecting vitamin B12 into the infraspinatus muscle (located over the scapula, aka the shoulder blade), is used to treat asthma!  That's right: a vitamin... injected into a muscle... can help a respiratory condition... like asthma.  That body is so weird at times. Research papers supporting this theory are located here and here. 

Mechanism: it is believed that asthma is often due to a sulfite allergy. As a result, vitamin B12 (aka cobalamin) can help because it helps to produce a sulfite-cobalamin complex that blocks the action of sulfites in the body. It also decreases bronchospasms caused by sulfites due to its oxidative nature in the body.

Year 3, Semester 1, Class Review, Part 2.

The other half of this semester's classes...

(Clinical) Nutrition - I've always loved nutrition and this class is no exception.  So far I'd say it's not as good as last year's game-changing learning experience, but it's still very enjoyable. We are given cases to work on (so many cases this year!) and we do a lot of reading from our hefty textbook.  This class is so material dense that we actually have two textbooks that we have to lug to class each time. By the way, if you think nutrition = diet, you are very wrong. Contrary to common belief, we don't even talk about food during nutrition class. In fact, the class is very, very medical, but more on that tomorrow...

Physical Medicine - I already talked about this class here. Lots of material, but interesting stuff.

Radiology - The whole class is spent looking at X-rays. Enough said. Oh, and the prof is a funny guy too.

TCM/Acupuncture 3 - TCM is so much fun! It's been less than a month of classes and I've already learned so many cool techniques, like a form of acupuncture using heat only (no needles), different ways of inserting a needle (surprisingly there are tons of insertion techniques, way more than just 'poke needle into patient'), how to reduce the appearance of scars with acupuncture, and acupuncture for additions management.

Homeopathy 3 -Live patient intakes in class and then a whole lot of homework. That's it.  While I don't like homeopathy, I like seeing the doctors perform thorough patient intakes before my eyes.

Scarfs for all Seasons.

Image source here.

I used to think that people only wore scarfs to be fashionable, but I've since learned that they actually have health-protecting benefits. 

For instance, late last winter, I posted the Chinese Medicine theory regarding scarfs on the blog.  (To remind you: the theory is that scarfs protect against colds and flus that enter through our vulnerable 'wind gate'). 

Yesterday, I learned another reason why wearing a scarf is a great idea during colder months in my Physical Medicine class: scarfs keep neck muscles warm. 

During colder months, it is important to keep neck muscles warm. When muscles are warm, they are also relaxed. On the other hand, when muscles are cold, they are tensed. Chronically tensed muscles lead to neck pain and even headaches. Other symptoms such as jaw pain and vision problems have even been linked to tense neck muscles; crazy!

Scarfs can be worn in Summer months too, especially in you work/live in drafty offices/buildings or ones with blasting air-conditioners. My professor explained how air-conditioners have been linked to neck problems because the frigid blowing air makes exposed neck muscles cold and tense (possibly leading to neck pain and headaches). Good thing scarfs are fashionable in the Summer too! :P

P.S. Happy Love Day to my Momma and Papa!

Physical Medicine.

The main naturopathic modalities that I will be using as a future ND include: nutrition (diet and supplements), botanical medicine, counseling, hydrotherapy, and physical medicine. 

When I first started at CCNM, and when these modalities were first introduced to me, I naively thought that physical medicine only consisted of massage and manipulation (aka chiropractic medicine). This year, however, I am learning that physical medicine is so much more! In third year, students take the course 'Physical Medicine'.  I've only had four classes of 'Phys Med' thus far, but boy have a I learned a lot of new therapies. 

Physical Medicine appears to be the best modality to body complaints; things like: sore muscles, sports injuries, strains, sprains, back pain, tension, nerve impingement, scars, etc. Phys Med involves a lot of pain management and techniques that encourage healing. 

Some of the Phys Med tools that we will be learning this year include (learning both theoretically and practically (i.e. hands on)):


Ultrasound: Not just an imaging technique, but a treatment too!  The ultrasound head sends sound waves through the tissue.  The sound waves cause internal vibrations, causing collagen re-growth promoting repair or increasing heat (heat is important in the tissue repair process, it means blood, hormones, growth factors, white blood cells (mast cells), and other repair elements are coming to the injury to fix it up). 

IFC (interferential current therapy): Very gentle electrical impulses are sent through the tissue surrounding the injury/pain. This low-frequency stimulation/vibrations causes the body to send healing factors (see above) to the site, helping to heal and relieve pain. 

Lasers: Similar to ultrasound and IFC, lasers use light beams to heal the damaged tissue/painful area by encouraging collagen regrowth and all those healing factors (see above) to the site. 


Who would of thought that sound, electrical current/vibration, and light could be so good for the body!