Examageddon

Eleven exams and a third year of naturopathic medical school are over!

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.

Eleven

Eleven final exams and year three is done-and-done. 

Please bear with me over the next two weekn as I prep for and write my exams; I may not be blogging regularly. 

Good luck to all CCNM students writing exams! 

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. 

Bittersweet

I am about to begin the last.week.EVER.

That's right: this week is my last week of classes at CCNM! 

No more pencils, no more books, no more teachers' dirty looks... 

This post is titled Bittersweet for a reason, however.

While I am so, so excited to get out of the classroom and into the clinic, I'm a wee bit sad about ending almost two decades of classroom time. I like being a student, it's what I know! I love learning, I love taking notes, I love hearing from experts (my professors), I love seeing my classmates everyday, and I love routine. I know that the learning won't stop (my patients will become my new teachers!) and I'll still see my colleagues around the clinic, but it will be different. Good different, but still different. I'm sure the month of May will be pretty stressful as we all adjust to this new system of learning. But by Summer, I'm sure we'll have mastered the operations portion of our year four experience (charting, audits, case management files, the PAX booking software, taking out equipment, changing treatment rooms, monitoring modality numbers, ICD codes, and so much more). And once those headaches are out of the way, it'll be smooth sailing: we'll be back into a routine and our patients will dictate the course of last year of formal learning.

But in the meantime, I'm going to soak up this last week of being a student... a mere third-year... spending my days in the Lecture Theatre... comfortably seated, just one in the crowd... trying to take in as much good knowledge as I can...

...while waiting for the next bathroom break to chat and complain with my peers about the eleven exams that stand between us and clinic. Eek!

Body Monologues, On Stage

Last night, I volunteered at (and later sat in the audience and watched) this show. I'm kind of obsessed with Body Monologues (BM), the charity behind the 'On Stage' show that took place last night. What is BM? Well, according to their website: Body monologues is a space for sharing and creating awareness and dialogue about our experiences in our bodies. It is about learning to take care of our bodies, learning to enjoy them, learning to appreciate them, and learning to honor them. It is about the journey from self hate and self abuse to self acceptance and self love. 

Image retrieved from the BM website

If you've ever seen the Vagina Monologues, BM is sort of similar. But not... Allow me to explain: First of all, they are REAL stories. Second, the monologues talk about much, much more than vaginas! Heck, at last night's show, a man presented his own body's monologue! There are stories about every body part you can think of. Third, the way in which the monologues are presented varies heavily. Some are sad, funny, accompanied by music, song, video, props, and/or dance. 

What I love most about BM is the bravery of those who present. They are so brave to share their personal struggles with complete strangers, and so, so brave to say what they are feeling out-loud. The power of talking out-loud about your body struggles is huge and can be incredibly healing. The performers must have completed a lot of personal reflection in order to reach a level of comfort within their body to be able to share their story.

If you have a body struggle and are not ready to share it on stage, in front of strangers (albeit incredibly supportive strangers!) and if you are not ready to talk about it to a friend, family member, colleague, doctor, or counselor, then I encourage you to at least journal about it. Expression of any kind, whether it be in text, art, movement, or spoken-word, is helpful in healing. It gets the struggle that may be buried deep within us, out to the surface, a place where it can more easily be released... to be let go. You could even try writing your own body monologue in private and maybe one day, at a future BM show, you'll be ready to share it!

For more information about Body Monologues, please check out their website.

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!

NDO Spring AGM Recap

Today I attended the Naturopathic Doctors Ontario's (NDO) Spring Annual General Meeting (AGM). I think I was one of maybe four students in attendance... the other hundred plus people were practicing NDs. Lots of my professors were in attendance as well as some "famous" NDs. The beginning of the meeting featured a presentation about where NDs in Ontario are regulation wise. From what I could tell (it's a complicated and lengthy process), naturopathic doctors in Ontario are on the cusp of obtaining prescribing rights. The transition council has continuing education courses already geared up and ready to go to begin training NDs on the new products, supplements, and drugs, that they'll be able to use once the prescribing rights are obtained. However, notez bien that by having prescribing rights does not mean that Ontario NDs can start dishing out drugs. It really means that they'll be able to officially "prescribe" a chamomile tincture rather than "recommend" it, as we currently do. Nevertheless, believe that we'll have access to some synthentic pharmaceuticals too, but those details won't be confirmed until August 2013.

Later on in the meeting, the floor was open for NDs to ask questions and speak their mind. Some comments were quite loaded, while others were clear and simple. It was very cool to watch as a non-ND but future-ND. I wonder how passionate I'll feel about these topics when I'm in their position...

After a bit, lunch was served. Gluten-free and dairy-free, including the dessert, which was nice. Over lunch, the official AGM portion of the meeting took lace; I couldn't vote as I am only a student, but I stuck around to hear what was discussed nonetheless.

The lunches were even branded with the new NDO logo.

The NDO has had a lot of changes in the past year, so there was a lot to talk about, including a new CEO and a new name! The new name, NDO (it was formally the Ontario Association of Naturopathic Doctors (OAND)) was officially adopted at this meeting, as well as the organization's new branding and website, found here.

Lastly, there was a presentation on optimizing social media... but I left early and didn't attend this. Even though I am a blogger, I pretty much hate social media and how we students keep being told that "social media is key in building a practice" without any evidence given that this is true. Boo!

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!

Twist and Shout! Formal 2013

CCNM's Annual Formal took place exactly one week ago (on March 9, 2013). Once again I was on the formal planning committee; this year I was in charge of the volunteers and communications. It was quite the event with ~500 people in attendance. The theme was the 50s & 60s, and there was a swing cover band; as a result, the dance floor was totally rockin'!  

Old School Candy Station

The Night's Signature Drink: Blue Moon

Centerpieces were Ice Cream Floats made with Carnation Flowers and Records

Swing Cover Band

Party Favors were Old Fashion Sodas, like Cream Soda and Root Beer

Monday Morning Dangers

It's beginning to feel like Spring here in Toronto! Today is 12*C and partially sunny. With daylight savings occurring today, that means we'll get to enjoy this sunshine thanks to more daytime hours.

With that said, please be careful driving to work tomorrow. The morning after the Spring daylight savings time adjustment is one of the most dangerous times to drive, as I discussed last year.

Secondly, because tomorrow is Monday, be extra easy on yourself, as research shows that the incidence of heart attacks is highest on Monday mornings. This paper concludes that: "The incidence of sudden cardiac death is markedly increased on Monday". 

The day after daylight savings plus the fact that it is a Monday = one very dangerous day

So take care of yourself tomorrow morning, dear reader. Take care! 

A Day in the Life, Part 1

Inspired by this post. 

8 AM: Oats & Tea.

9 AM: Welcome to School.

10 AM: Learning About Labor.

11 AM: Working on My Cookbook in Class. Oops!
 

12 PM: This Salsa Rocks.

1 PM: Canadian Geese by the School.

2 PM: Love is All Around.

3 PM: Snack Attack (Homemade Granola and Almond Mylk).

 4 PM: Reading Time (with Soda Water).

5 PM: Greens are Beautiful.

6 PM: Egg Fried Rice is Very Nice. 

6 PM: Dessert (Dark Chocolate with Fruit Undertones).

 7 PM: Computer Time & Tea Time.

8 PM: Lounging.

9 PM: Crazy Book.

10 PM: Nighty Night.

...and we're back!

...back to school, that is. 

After 2+ weeks of reading week and midterms, today was the first day back to school. It was busy being back to the grind, but I missed the hustle of bustle of daily school (however, some aspects were extremely stressful, so I hated those parts of today... more on that in another post). Also, now that it is March, things are busy again so I can't guarantee daily posts. I'll pop in as much as I can, but if I don't post, it's because life and school are really hectic!

___________________________________ 

Check out this awesome Canadian health news! I've talked about dandelion root in the past as a good liver detoxifier and replacement for coffee, but who knew that it fights cancer? I'm actually having a cup of dandelion tea right now as I type! Here's my favorite brand, but you can also buy this one, or this one. Or, as explained in the news article, you can make your own by grinding dandelion roots!

Image taken from the Traditional Medicinals website. 

Massage Memories

I visited the Royal Canadian College of Massage Therapy located in Toronto recently. They operate similar to CCNM, in that they have a teaching clinic where the students work under supervisors near the end of their studies. Since the practitioners are still students, the massage fees are greatly reduced too.

Image from the RCCMT website. 

The best part of attending the college was not getting the massage (the massage was actually quite rough! Definitely not relaxing, but structurally therapeutic in that the student worked heavily on the tight muscles)... but was being reminded of all the massage techniques I learned in my first-year Massage class. Here is the link to all of my posts that talk about Massage from year-one at CCNM.

The entire massage experience was a giant flash back to what I learned in year-one. We were trained in all of the basic massage techniques and were taught by Registered Massage Therapists (RMT). I remembered the draping, the pillowing, the names of the different massage techniques, the correct terminology (you lie on a table, not a bed!), the etiquette, the sequence of events, and much, much more! I am really surprised at how much I recalled. Now I know that in the future, when I forget a modality or technique taught in class, I just need to go and experience it as a refresher! It's amazing how quickly the material comes back once the memory is prodded.

The Naturopathic First Aid Kit/Pantry

I've been tallying up (in my head) all of the naturopathic medicines we keep naturally in our household. Products that you probably already have in your cupboard, but maybe didn't know that they could be used medicinally. While seeing a naturopathic doctor isn't cheap (unless you have private health insurance), a lot of the things that an ND will recommend are very inexpensive and are even free if you already keep a well-stocked pantry. It's what I love most about naturopathic medicine: finding natural ways to take care of ourselves. It reminds us that food (and other household goods) is medicine!

Below is my running list* of things that should be kept on hand as part of the Naturopathic First Aid Kit (also known as the Naturopathic Pantry). Most of these items are likely already kept in your the kitchen!

*This list a work in progress. I will continue to update this list as items come to mind. Feel free to add items to the comments of this post if you think of others.

Naturopathic First Aid Kit/Pantry

Coconut oil - great for skin as a moisturizer, use to make deodorant
Oats - for itchy skin add to baths, eat to relieve constipation, use in homemade face masks
Rice - use to make for congee (especially when experiencing gut troubles), part of the BRAT diet
Socks (thick, wool socks and a pair of thin, regular socks) - perform "wet socks" when getting sick
Ginger chews - for nausea, helps digestion after a big meal, carry on plane trips for motion sickness, warming after eating something cold/cooling. I like this brand.
Unsweetened cranberry juice - for urinary tract infections (UTIs)
Peppermint tea - to combat colds, helps digestion (don't forget to cover it)
Chamomile tea - to sooth tummy aches, helps babies teeth
Black tea - stops bleeding
Epsom salts - add to baths to relax muscles, great for injuries
Raw honey - dab onto acne (antimicrobial), make homemade cough syrup, mix with hot water and lemon when sick, soothes sore throats
Sea salt - gargle when sick, use as a natural exfoiliant when mixed with coconut oil (rub the mixture onto the body in the shower then wash off)
Apple sauce - part of the BRAT diet, replacement for eggs
Flax seeds - helps regulate hormones (part of the seed protocol too) good during PMS and menopause, replacement for eggs, 10 ways to eat more flax here.
Cayenne pepper - sprinkle on cold toes, a natural decongestant when eaten or inhaled
Olive oil - use to dilute essential oils, heart protective
Oranges/tangerines - dry the peels, then steep in tea to help digestion (dampness in TCM), eat when getting sick for the vitamin C and flavinoids
Onions - apply to ear during an ear ache, make homemade cough syrup, eat lots when sick in soups
Garlic - eat when sick in soups, lowers blood pressure, is anti-microbial
Lemon - in water it has many uses: acts as digestion stimulant, it helps the liver detox, flavors water, and drink hot when sick with honey
Kettle, bowl, and a towel - use for steam inhalation (place boiling water from the kettle into the bowl, place your face above the bowl, and wrap your head with the towel, trapping yourself into a little tent full of steam), add essential oils to this (~5-10 drops) if you have them

More: check out my post on culinary spices as medicine and one on herbal teas. 

Opportunities Abroad, Part 2

While studying naturopathic medicine at CCNM, you can learn beyond the classroom by taking a trip to... 

Nicaragua - volunteer in a community health clinic for ten days. Learn more about this clinic and NDI (Naturopathic Doctors International), the organization behind this trip, here. 

Guatemala - volunteer in a community health clinic for ten days. Learn more about this clinic and NMGH (Naturopathic Medicine for Global Health), the organization behind this trip, here. Fellow blogger T is on this trip right now! 

Haiti - volunteer in a community health clinic for ten days. Learn more about this clinic and NWB (Naturopaths Without Borders), the organization behind this trip, here.

India - travel to Mumbai where to study (during the day) homeopathic medicine under the supervision of famous homeopathic doctors. During the nights, you are free to explore and immerse yourself in Indian culture! NOTE: unlike the other trips, this is not a volunteer opportunity but a continuing education/course work-style trip. 

...with all these opportunities, it is evident that naturopathic students like to travel!

Source

Chocolate Love

All of my friends gave me chocolate yesterday. They know me well!

Mmm, chocolate coma!

On VDay I gave out homemade peanut butter cups wrapped in foil just like real chocolate.

Homemade Chocolate Peanut Butter Cups 

HOMEMADE PB CUPS... Reese's has got nothing on these yummy cups.

 200 grams of chocolate (equivalent to two bars)

0.5 cup of plain peanut butter (natural)

0.25 cup of honey

Melt chocolate on minimum heat. Take a mini muffin tin or a regular sized tin with a bit of oil to keep it well greased. Spoon melted chocolate into the bottom of chocolate (a little more than a teaspoon). Then place the muffin tin in the freezer for 5 minutes to firm up. After 5 minutes, take a heaping teaspoon of the honey PB and roll it into a ball, then flatten it it into a disc. Place the disc ontop of the chocolate base in the muffin tin. Make sure that the disc is not as wide as the entire tin's width (you want room to get chocolate on the sides of the PB disc). Then pour chocolate on top of the disc, making sure that chocolate gets all around the disc and covers the top entirely. Continue until all the cups are filled with discs and covered with chocolate. Garnish with a peanut and place in the freezer to firm up for another 5 minutes.  To remove the cups, use a spoon to "plop" the discs out. They will seem stuck but they will pop out easily due to greasing them in advance. Makes 12 mini PB cups or 6 large ones.

Share with those you love! <3

Substitutions: use maple syrup instead of honey and almond butter instead of PB.

Have a LOVEly day!

Fruit and vegetable love: how suiting for a naturopathic, health focused blog!

Ah Valentine's Day, the commercialialized day of love. A rip-off in many aspects (overpriced flowers and 3-course meals, false expectations, a whole lot of pink junk on store shelves...you know what I mean). Nonetheless I am a big fan of this holiday. What can I say: red is my favorite color, I love holidays at school (everyone us full of spirit), and I love chocolate...three things that V-Day offers.

Regardless of whether or not you are celebrating today, I hope you have a lovely day! 

Phew, January is over!

Well, January is officially over.

It was the busiest month that I have ever had at CCNM. You can expect way more blog posts now that February is here because I will certainly now have more free-time. It was a month of challenges, being put on the spot, and testing my "doctor skills". Overall, despite being busy, it was a super fun month!

I am actually loving third-year. It is challenging and fast-paced, but it is very motivating and "real". No more learning the theory behind something... instead we are actually doing that something. When I first started third-year I absolutely dreaded the Winter semester (what I am going through now). However, as I was going through the worst of it (the month of January) I found myself really enjoying the process! I was rarely stressed or worried. I guess my confidence has been built up high enough that I am  actually feeling great about my abilities to "play doctor" and therefore I don't worry or fret about the times when I will have to perform what I've learned in a timed and tested environment. For example, OSCE 3 is coming up and I am not feeling the least bit worried. It is nothing more than another hurdle that I will have to get-over in order to becoming a ND.

January featured...

1) Performing three phlebotomies (aka blood draws from a vein)

2) Being Scribe in Primary Care for a disc hernation case

3) Being Doctor in Primary Care for a positive HIV patient case

4) Performed my first spinal adjustment (and have since done three adjustments a week on my partner)

5) Continued to see patients in Clinic while shadowing a fourth-year intern

6) Attended two pediatric appointments; during one I got to perform a physical exam on a 2-year old. So adorable!

7) Volunteered several times at a chocolate company here in Toronto and also at the naturopathic medicine-geared business class

8) Conducted another Chinese Medicine patient intake and provided treatment regarding my patient's TCM diagnosis

9) Finished 99% of the organizing for Women's Health Week (coming up in March!)

10) Worked on CCNM's formal committee (an annual formal-dress dance/dinner), keeping the volunteers in track and working on ticket sales (also in March!)
11) Performed my first gynelogical exam on a female patient
12) Performed my first genitourinary exam and digital rectal exam on a male patient
13) Spent a lot of time on my cookbook. Things are now moving along nicely!

 

Well, it's pretty much smooth sailing from now until the mid-March. Come mid-March I'll get super busy again due to Women's Health Week, formal, and our third and final OSCE exam!

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.