Year Two Overview.

It's time to look back at year two.  Here's the good and the bad (in no particular order):

Image source here.

BAD:

 - more class time (almost 9-5, five days a week)
- more depressing (likely due to year-long Pathology and Microbiology courses, which aren't very pretty)
- weak, weak, weak psychology/counseling training this year, which was disappointing
- less of an 'naturopathic' year (likely because the courses were science heavy and less training in the modalities)
- decreased class-wide camaraderie (but you'll see the good side of this below)

GOOD: 

- feel waaaayyy more like a doctor (thanks to PCD)
- less studying required (than in year one...I took the majority of weekends off from school)- much more relaxed atmosphere (it's like I got the hang of CCNM life :P)
- better schedule (not as many 830 AM courses, finishing classes at dinner time)
- much better understanding of Chinese Medicine after this year!
- feel like my brain is bursting with all of the amazing knowledge covered this year (I really did learn a ton)
- despite the decrease in class-wide activities, I grew closer with a smaller group of classmates, which was great

Thanks, Micro. You've ruined my life.

Good health is germ free health. Use the dispenser to keep hands clean. For everyone's sake.

I hate Microbiology. It's really ruined my life (note: I'm being somewhat sarcastic here) because I now fear bugs.  Bugs/germ/pathogens/bacteria/viruses/evil dudes are everywhere!  After learning all about microbes this past year, I know more than I care to know.  Sometimes I wish I were my old naive self, not knowing about the scary microbes all around me, living a more laissez-faire life.  Instead of this new microbe-fearing gal. :P

I saw this poster on the University of Toronto campus and it made me laugh (and cry) at the same time. I have mixed feelings towards its message.

It's true that there are some scary critters out there and that they can pose serious harm on your health, but this poster encourages a dramatic and exaggerated fear in those who read it. The poster also did well in the whole "fear me" department (it made me cry!).

Where I disagree: germ free health is not the pinnacle of health.  Today we actually do live fairly germ free due to our obsessive love of sanitizers, soaps, and cleaning agents... and this love has cause a whole plethora of other health complications (as hypothesized by the Hygiene Hypothesis) like asthma, allergies (food and airborne), eczema, autoimmune diseases, etc. Also, in our gut alone lives millions of microorganisms... and we most definitely need our gut micro flora for good health!  So, no poster, you are wrong, germ free health is not good health. 

What I do like about this poster is the "for everyone's sake" line.  It's true that public health is important.  This is why we are taught at a very young age to cover our mouths when we cough; it's not for our own safety, but for the health of those around us.  Remember that most microbes need human hosts; without somewhere to live, they can't survive. Thus when germs can't spread, they can't live.

Lastly, I am on the fence on the role of hand sanitizers.  I much prefer good 'ol hand washing to stay clean.  I worry that the sanitizers create super bugs by encouraging bacterial resistance.  I also think they promote a false sense of security: most hand sanitizers only kill bacteria (they are anti-bacterial), not viruses! 
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P.S. If you live in Ontario, please consider participating in the Ontario Health Study. You'll get a free $10 gift card for participating... and you'll support the greater good because public health research is so important!
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P.P.S. Final year-two grades were posted.  I successfully passed my courses.  Which means, onwards to year three!

Jealous.

I'm jealous.

While at school this week for my NPLEX course, I had the opportunity to jealously observe the third-year students.  This week they are back at school too, but under much better circumstances: they are completing their clinic orientation!  That's right, next week the former third-year students will become fourth-year clinic interns; counseling patients, writing prescriptions, drawing blood, creating tinctures ...and all that jazz. While watching them receive cool clinic gadgets (prescription pads, pagers, etc) wasn't fun, I had to remind myself that in only one year I will be in their shoes.

I'm still jealous.

But I'm so close. 

A jealously-themed cartoon for today's post. Poor mustard, I still love you! Image source here.

Year Two Picture Recap.

Above is a recap of my second year at CCNM.  These stats were written on a white board in the lobby of CCNM write after I wrote my last exam of year two!  I don't know who was keeping track of all of this, but I'm happy to now be able to look back at all the work completed and sigh with relief!

3, 2, 1...

3^3 exams written, 2 years completed, and 1 greater goal, now well within reach. 

Goodbye year two!

(soon!)

Coffee & Cholesterol

If you are concerned about your blood cholesterol levels, you should know this little factoid about coffee I learned last month in my Clinical Nutrition class. Image source here.

Cafestol, which is found in coffee, increases cholesterol by interacting with gut receptors that are responsible for regulating cholesterol levels. Coffee (because of its cafestol content) raises cholesterol more than any other food.

But if you love coffee and are worried about your cholesterol levels, never fear! There is an easy way to remove cafestol from coffee ...by using paper coffee filters! As long as you filter your coffee grounds through a paper filter, then the cafestol will be removed. However, this also means that instant coffee and espressos are the highest in cafestol, which could be bad news if you love these forms of coffee the best.

Apple + Chocolate

...and by referring to the combo of Apple + Chocolate, I don't actually mean a chocolate-covered apple!

What I do mean, is to share a piece of advice given to me by by grade 12 Law class teacher (rather my Droit teacher, because the class was taught en francais). He gave the class a piece of exam writing advice that I have never forgotten and still use his technique to this day.  Since I am using his technique these days as I complete my year-two final exams, I thought I would share it.  

Even if you're not a student, this technique can be applied to any activity that requires sustained energy and lasts about two hours long. Examples: hikes/long walks, shopping trips, cleaning the house from top to bottom, the last two hours of the work day, car trips, etc.

Here's the tip: 

Right before the event, eat an apple. The apple provides the body with energy by sustaining blood glucose levels over an hour or so period of time.  The fiber and water in this fruit buffer the release of the fruit sugars, allowing the body to have a gradual release of energy. This is important during long events such as writing exams or any of the activities above because we don't want to 'crash' or become very tired in the middle of them.  Then, during the last 15-30 minutes of the event (the 'crunch time' of the exam, or the last must-they-drag-on hours of the workday, or those last couple of highway exits before the destination is reached) eat a piece of chocolate.  Not a whole bar, just a square. Just enough to provide you with a burst of simple sugars and caffeine to give you the last bit of energy you need for that one last push!

So before I buckle down before that exam (that walk, those errands, that report that needs writing...), I eat my apple.  I also tuck a piece of chocolate into my purse/bag/hoodie pocket for later on, when I need my second wind.  Most chocolate bars come foil wrapped, so I just take a bit of this extra foil to wrap-up my chocolate piece.  Point of caution: don't put the chocolate into a pant pocket or in any clothing pocket that is really close to the body, for the heat of the body will melt the chocolate! Trust me on this one; I unfortunately had to learn this the hard way. 

And there you have it.  Who knew that apples and chocolate make the perfect energy combination? Mr. D did. Many thanks---after all those years of using his tip---to Mr. D!

Best Part(s) of My Day.

Best part of my day: Got to ask patients questions! I love the conversation/interview aspect of  appointments. Much better than the physical exam aspect.

...no, wait! Best part of my day was: Wearing a white coat & toting around medical equipment, like a boss.
  
...no, wait! Best part of my day was: Feeling very confident in the assessments of my two patients.  

...no, wait! Best part of my day was: Today's high of 25*C.  Hello warm weather!

...no, wait! Best part of my day was: Realizing that I only have three major exams left on the road to becoming an ND (OSCE 3, NPLEX 1, and NPLEX 2 remain... OSCE 1 & 2 are done and done!)

Worst part of my day: The subway breaking down on the way to my biggest and most important exam of this semester, resulting in me having to run to my exam in order to make it on time (and feeling like I was 'dying' from the additional stress that the subway stall added to my already stressed state). Not fun, but in hindsight it's a funny story to tell!

Overall, 'twas a good day.  A good day indeed given the circumstances. Hope your Mondays had best parts too!

Heavy Metals.

What a wonderful way to end year-two, with Dr. Phil! Dr. Phil was one of the most inspiring professors this year.  He taught the course Clinical Nutrition. I learned more in one of his classes than I did in after completing an entire semester in other courses. He ended the class wishing us well; telling us that we have entered a very special profession and that we are going to help many people's lives.  A simple comment, but inspiring and motivating... a lovely thing to hear especially when exams loom.

One of his classes earlier in the semester was about environmental medicine.  We talked about heavy metal poisoning (often a cause of Autism!).  He told us that whenever we see a patient presenting with neurological complaints (including Autism or an Alzheimer's-like presentation) or unexplained abdominal pain, consider heavy metal poisoning.  The follow are common sources of heavy metals. Remember, heavy metals are toxic!

Mercury:

•         Latex and paint

•         Polluted water

•         Broken thermometers

•         Vaccines

•         Fish (tuna!)

•         Dental amalgams

•         Pesticides

Lead:

•         Lead based paint

•         Drinking water (lead pipes)

•         Plastic mini blinds

•         Some fertilizers

•         Batteries

•         Lead glazed cookware

Cadmium:

•         Automobile exhaust

•         Water (galvanized pipes)

•         Tobacco

•        Refined flour/rice

•         Batteries

•        Metal rust-proofing material

Arsenic:

•         Insecticides (especially those for ants)

•         Wood preservatives

•         Shellfish

•         Well water

Aluminum:

•         Aluminum welding

•         Municipal water

•         Processed foods (pop cans!)

•         Antacid medications (like Tums)

•         Aluminum cookware

Tin:

•         Insecticides 

•         Food preservatives

•         Dental materials

•         Tin coated cans

School's Out for Summer.

No more pencils
No more books
No more teacher's dirty looks

Out for summer
Out 'til fall
We might not go back at all

School's out for summer

-- Alice Cooper (lyric source here).

Well, school's not officially out for Summer yet (there still remains two weeks of final exams), but today was the last day of classes! 

It is a bittersweet feeling to be done the year-two.  This program is flying by, which is both happy and sad.  Am I ready to actually treat real people? But going to school is fun! VERSUS I can't wait to have my own practice.  How wonderful to have no more exams, ever!  ...more reflections on year-two to come!  I have LOTS to say.

The fact that Summer is nearly here is also bittersweet.  I love seeing my classmates everyday and being in a school routine, but I need a learning break, a road trip, and more sunshine!

Oh, and in case you were wondering about We might not go back at all, don't worry because I'll definitely go back in September :) As much difficult as this program is, I still love it!

Goodbye, Greek.

I tried Greek yogurt for the first time in my life this week.

I became vegan before I had even heard about Greek yogurt.  But because I read a lot of food blogs (I am quite obsessed to be honest :P), I kept hearing about the wonders of this Greek yogurt. It kept popping up and I kept thinking that I just need to give this product a little taste. It is apparently a popular food staple for breakfasts, in smoothies, and as a condiment (like sour cream).  I contemplated for awhile whether or not I should give it a try (even though I now eat eggs and fish, I do not intend to reintroduce dairy into my daily diet).

Last week, I finally bought a tub of organic Greek yogurt (the one pictured to the right) just to see what all the hype was about. I was surprised how much it tasted like... yogurt. It tastes just like a remembered yogurt tasting, but it it thicker and sourer (probably because it was not sweetened, unlike the yogurts I used to devour years a go).  It was alright...  I'm glad I tried it, because now I know that I really am not missing much by keeping Greek yogurt out of my life.  Also, the dairy (after not eating dairy for almost four consecutive years) didn't quite agree with me. Not in a ohmygoshIfeelsosick kind of way, but in a rumble-y tummy and irritated bowel kind of way (but I'll spare you the specific details). Enough malaise to know that dairy is just not for me.

Nevertheless, if you do choose to eat dairy, I'm thinking that organic Greek yogurt is probably one of best sources of dairy available.  It's organic, contains good bacteria (probiotics), calcium, lots of protein (18 grams per serving), and is sugar-free (if you buy plain that is).

I will finish up the tub of yogurt I have already purchased (I hate food wasting!), but then it's goodbye, Greek.

Cancer and Anemia.

Sometimes people with cancer become anemic as a result of their cancer, treatment, and weak body.  I find the processes (there are four, listed below) that cause this anemia to be quite interesting.  (Note: anemia is when the body doesn't have enough iron.  The main symptom of anemia is fatigue).

1) Cancer cells sequester iron because they need it for their metabolism. But so do normal cells. As a result, the body "hides" iron from the cancer cells in the liver. The body stores it instead of using it.  The body also wants to "hide" iron so much that it downregulates new iron synthesis too.

2) Inflammation, due to the war between the immune system and the cancer cells, causes the liver to stop making iron (iron restricted erythropoiesis) and decreases the synthesis of erythropoietin (EPO). EPO normally stimulates red blood cell (RBC) production, meaning more iron is made (every RBC contains one iron molecule). The inflammation also causes the bone to stop responding to EPO, meaning fewer RBCs and thus less iron.

3) Nutritional deficiencies contribute to the low iron levels (cancer patients have poor appetites and thus aren't typically eating iron rich foods).

4) Chemotherapy (chemo) treatment also makes the bone marrow not respond to EPO (as did the inflammation above). Chemo treatment also decreases appetite and evokes vomiting, adding to the nutritional deficiencies (described above).  Surgery in conjunction with chemo may result in some blood loss, causing blood/RBC loss and yet again iron.

I find these connections to be fascinating, but maybe that's because I am a science junkie :P  If this blog post was too technical don't worry, because I'll be back tomorrow with a nice and sweet (literally) post about chocolate :)

NPLEX on the Horizon.

Outdoor studying? Hopefully! Image source here.

Summer begins in exactly one month! Exciting times, my friends, exciting times.

However, this Summer is not going to be typical because I have to write NPLEX 1 (Naturopathic Physician Licensing Exam). These exams are like my board licensing exams. I write round one this Summer (2012), and then round two in the Summer of 2014. Round one tests my knowledge of basic sciences, like Anatomy, Physiology, Biochemistry, Microbiology, Immunology and Pathology. Pretty straight forward regurgitation stuff. Round two is where the real Naturopathic questioning begins. This exam tests students on the modalities (Botanicals, Nutrition, TCM/Acupuncture, Manipulation, etc).

NPLEX 1 requires about two months of solid studying (you have to review all the basic science stuff taught in two years remember). For the months of June and July, I will have to treat studying like my job; meaning eight hours a day, at least five days a week, of cramming (and more when the exam date draws near). Fun times on the horizon, right? Ha ha. Well, at least I have May to look forward too (minus the NPLEX prep course I have to take, doh!) ;)

Nutritional Prescriptions.

Last week I commented that I've been learning "life changing stuff" in my Clinical Nutrition class. I really have. I feel that this class (out of all my second year classes) has best equipped me with tools needed to treat real patients with real conditions. This class is also the most motivating in the sense that I end each class very empowered, proud to be studying naturopathic medicine, and more confident that I'll be able to (one day) change patients' lives.

Even though I am so excited about this course material, I oddly enough feel like I can't share what I am learning on my blog. We've learned a lot of treatment protocols and nutritional prescriptions that I don't feel comfortable highlighting on the blog for fear that someone might apply the material to themselves without the guidance of a health professional. Supplements (and even some foods) are powerful tools to be used to achieve wellness, but when used the wrong way or without support, they can also be very harmful. So sorry to leave you hanging, dear readers, but you'll have to wait until I am in practice to learn the amazingness of nutritional supplements and prescription foods.

Isn't it crazy that you can buy iron tablets and vitamin A drops at any old drug store or grocery store. These are not benign candy but are health-altering (for better or for worse) substances! After what I've been learning in my Nutrition, Botanical Medicine, Pharmacology, and Physiology classes, I'm surprised that some foods don't come with warning labels (I'm looking at you grapefruit and parsley... but there are many others seemingly healthy foods that in some cases are dangerous, and then there are the obvious health-harming foods that you can buy willy-nilly like MSG, hydrogenated margarine, cola, etc).

It's actually pretty crazy that most people don't realize the power that food, vitamins, and minerals, can have on the body. Eating 12 almonds a day really can't lower my bad cholesterol, but this plastic, little white pill sure can! How is that we can trust these foreign and synthetic drugs to cure us, yet be suspicious of the fruits of the Earth? Why do people look at me funny when I say that herbs can heal when the majority of pharmaceutical drugs are nothing more then replicas/synthetic versions of natural plants? It boggles my mind. What caused this shift and how can I reverse it?

By being a good Naturopathic Doctor, that's how. I dream of the day that I can help heal patients with nutritional prescriptions ("eat this, this, and this, all call me in the morning!") and maybe a supplement or two (how about some melatonin for that insomnia you've been battling as of late?). And once I help them, that hopefully these patients will begin to believe in the healing properties of nature.

Image source here.

Beaches & Bravery.

BEACHES: It is March. And I have a sunburn. Well imagine that... I had the lovely opportunity to spend Wednesday afternoon with some classmates at the beach! It was my first time visiting "The Beaches" of Toronto. It was certainly a nature cure day. It felt so good to leave the dark and dreary classroom behind and embrace the salty air and the sun kissed skin.

BRAVERY: I performed a full acupuncture protocol on a classmate this week. I even did the treatment technically without supervision (shh, don't tell!) which made it all the more exciting. The classmate and I selected the points to needle together and I trusted my 2ish years of acupuncture training to determine the duration of treatment and the depth of needle insertion. My acupuncture confidence has been heightened to new levels now that I've had the opportunity to treat a 'patient'.

Weather.

I've been thinking a lot about the weather lately, probably because it has rapidly changed in last couple of weeks. Today I'll touch on three weather-related thoughts that have been on my mind:

Thought #1: Community & Weather. What is the one topic that everyone can chit chat about? The one subject that strangers can converse freely about? The weather of course. The weather connects you to the members of your community. On that note, it's funny how good weather can make the community happy and full of life, while bad weather brings out the grump in us all.

Thought #2: Health Benefits. I would love to do a study on the amount of colds experienced by people living in the tropics versus those living in Northern Canada. I bet people living in climates with warm and bright weather suffer from fever colds and flus. When the weather is good and the sun is shiny, people just feel better. Is it the sun and its abundant supply of vitamin D that is causing the heightened mood and overall healthier state? Or are the happy feelings that are brought out by good weather making people healthier? Is the increased wellness due to physiological (body) benefits or psychological (mind) ones?

Thought #2: Panic. Here in Toronto at least, we went from Winter straight into Summer. I'm not kidding: the weather has been hovering in the 20s (degrees Celsius) for about a week now. On Wednesday, the temperature is predicted to be 26*C! People are sporting flip flops, shorts, and sundresses. Rightly so: it is hot out there! But am I the only one panicking? If we are sweating in March, I can't imagine what August is going to be like?! This is not Mother Nature being kind to us by offering up some gorgeous weather. Nope, these are signs of full fledged global warming, my friends. There is no denying that globe is overheating. I desperately hope that policy makers and government are taking note of the situation. I don't want to come across as being too dramatic but.... It's not time to party, it's time to panic!

Image source here.

Formal Pictures.

The CCNM Winter Formal was a week ago. It was held at the Liberty Grand. I was on the planning committee and second in charge, so it was a special (albeit stressful) event for me! The theme was Las Vegas. Here are some pictures of the night (click to enlarge the pictures to get a better look as they appear tiny). Starting clockwise, top right, are pictures of: a champagne fluet with raspberries (mmm), a Chipendale's handmade table centerpiece (each table was decorated differently), my half eaten vegetarian entree (not bad especially since it contained protein and wasn't pasta!), the 'card shark' table centerpiece (made by yours truly), the specialty drink choices at the bar, a Liberty Grand napkin with appetizer spring roll, and lastly a handmade viva Las Vegas sign. 'Twas a fun night.

Note: I added two congee pictures to yesterday's post.

It's that "Change of Season" Time Again.

According to TCM theories, we are smack-dab in the middle of the another Change of Season (the changing of Winter to Spring). The last 18 days of a season are transition days and are also Earth element days, which may be why my Spleen has been acting up (Spleen is an Earth organ).

This time of year is hard on our bodies because the weather is very wonky (it was +14 and sunny on Wednesday, then today it was -2 and snowy), confusing our bodies and immune systems. Try to take extra care of yourself until Spring starts (March 21). With all of the wild wind these days, don't forget to still wrap yourself in a scarf before leaving the house. Now is also a good time to make a batch of Change of Season Soup if you have it on hand (I hope to sell packages of this soup mix at my future practice; it is tastes surprisingly pleasant and is very soothing).

In celebration of the Earth element, I decided to try making congee. One classmate of mine has this porridge-style dish every morning and I've been wanting to try it for awhile now. Another classmate recently posted a savory version of the dish here. Well, my troubled Spleen (see above) finally gave me the kick-in-the-butt I needed to get into the kitchen and make it myself! Congee is a slow-cooked porridge-like dish made of rice and water. It is a popular dish in Asian cultures. Rice is cooked very slowly and for a long time to fully cook the rice; cooking it until it resembles... mush. The point of this dish is that the rice has been cooked so long that it is basically digested, making it very easy to eat when the Spleen (the organ responsible for digestion) needs a break. When served warm with some spices (think cinnamon and ginger), it is very soothing and warming. Comfort in a bowl!

Basic Breakfast Congee

1 cup brown rice
10 cups water

Bring the water and rice to a boil, then reduce to low heat. Cover (leaving a tiny gap for steam to release) and let it cook on low for five hours. Serve warm with cinnamon and ginger (chopped fruit--like dates or raisins--and nuts or seeds are all optional toppings). Makes 6 servings. Reheat leftovers before serving (the Spleen likes warm foods!).

Women's Week.

This week has been all about women.

On Monday, we learned how to preform breast exams. In CCNM's teaching clinic, in groups of 3 or 4 students, under the supervision of a Naturopathic Doctor, we were able to practice performing the exam on real patients. I must say is that the "Naturopathic" breast exam is much more in depth than an Allopathic breast exam. The exam should take 2-3 minutes per breast and it covers not just the breast tissue, but the entire rectangle of skin between the clavicle, sternum, 5th rib, and the midaxillary line (aka the imaginary line that runs through the center of the armpit downwards). Breast cancer can metastasize anywhere within this rectangle area, so Naturopathic Doctors are thorough with their technique to detect any abnormalities that may be present.

On Tuesday, I had the wonderful opportunity to attend a women's only hydrotherapy spa. I've been wanting to attend this venue since I took my Hydrotherapy class last year. Clothing at this spa is optional, but I wore a bathing suit :P I alternated between warm, very hot, and freezing cold temperatured pools, saunas, and steam rooms. This alternating hot and cold circuit allows the body to be 'treated' by the waters. I loved the experience, even though some of the circuit steps were far from relaxing; stimulating may be a better description. My skin felt incredible and I slept like a baby once I got home that night: it just goes to show how therapeutic water can be!

On Wednesday, we learned all about the female genital organs (vagina, uterus, ovaries, etc), including relevant pathologies. We were also (briefly) taught how to preform the female pelvic exam. Next week we'll be able to practice using plastic simulators. We won't be able to preform a true pelvic exam (on a real patient) until third-year.

Lastly, Thursday (today) is International Women's Day (if you want to learn more, check out Google's front page). I recognize the importance in celebrating the progress that has been made in bringing men and women to the same level; however I consider myself more of an equalist. I want to see men and women treated equally, meaning that for every Women's Day, shouldn't there be a Men's Day too? Nevertheless, today's holiday is a nice way to end my women's health-themed week.

Image source here.

Spring Day.

On Friday, I had the most wonderful Snow Day... err, Spring Day! My Clinical Medicine professor gave us an independent study day, meaning a day that we didn't have to come to class! It was such a treat. Such a small gesture on the professor's part, but it meant so much to us burnt-out students.

Friday felt like I was a kid again and the radio just announced that it was a Snow Day, only that the weather was beautiful, so it was more like a Spring Day. Spring is just right around the corner, and while this Winter has been a calm one, I can't wait for sunshine and flowers!

I was able to sleep-in, leisurely eat breakfast while catching up on blog reading, pranced around in the gorgeous weather, went to both the library and market, and I finished the day in bed with a book. 'Twas a lovely day.

I want to point out that many working folk reserve their vacation days for times when they can get away, travel, and do something special. But sometimes the go-go-go nature of working then traveling/vacationing is too taxing on the body and the mind. Sometimes just taking a day--a Snow or Spring Day, if you will--to do nothing but relax and stay close to home can be more uplifting and fulfilling then any cruise, car trip, or concert could ever do.