Construction Consternation – Embracing Change

Spring brings about many changes – at the office the most notable is the sea of orange pylons, cavernous holes in the middle of the road, grumbling machinery, and the not-so faint smell of fresh asphalt. After battling with 3 months of construction on our poor roadway all of last summer, yet again we are in the midst of a seemingly unending road redo.

Patients are late, parking is overflowing, and co-workers are getting, umm… restless. Our neighbouring businesses that rely on walk-ins and street traffic are no doubt suffering. A particularly cheeky business neighbour even changed their advertising sign to “This Construction Sucks”.

It’s true – change is hard. It’s easy to look past why we need change, and forget our ultimate goal when we start to struggle. In the office we seem to have forgotten how bad the street use to be, all the potholes, temporary patches, heaves, and crumbling curbs.  And I’m sure we will forget our two-summer struggle once we have a cleanly paved, pothole free street. 

Sometimes in health we suffer from the same routine amnesia. It is easy to forget how bad a health condition was once it’s gone, and sometimes it’s difficult to remember why we chose to change. That’s why it is so crucial to measure change, however we choose to do it. Whether it is a sleep journal, a log of daily energy/mood, or even (dare I say) a chart of bowel movements. Sometimes a reminder of the way things use to be is the best motivator for sticking to the positive change one has made.

I hope construction is done soon, and that the small businesses up and down our road continue to flourish. I’m thankful for the hard work done by the city and the construction crews. I promise to remember the way the road use to be, and the struggle through the days of construction in order to truly appreciate the new roadway (whenever its finally here).

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Beating the Cold and Flu Season

This year’s cold and flu season has hit hard!  Over the last two weeks there have been a large number of patients (as well as receptionists, coworkers, friends of coworkers, family members, neighboring business employees, window cleaner, snow removal guy, even the postman etc) coming in for cold/flu treatment advice. Here are a couple of things I discuss with the cold stricken and flu ridden:

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Wash your hands!

You probably hate getting sick – so does everyone else! Be a good neighbor and wash your hands regularly to keep your family and friends from getting sick too. Better yet, when in the throws of the cold/flu stay home, and stay away from people!

Hydrate

Drink plenty of fluids, mostly water, and avoid sugar-sweetened beverages. A bump in blood glucose will actually decrease your immune function!

Zinc

It’s not flashy, it’s not fancy, but zinc is effective at shortening the duration of a cold. Zinc lozenges are a great way to prevent and treat the beginnings of a cold – especially if  a sore throat is involved.

Eat, Sleep, Be Well

Eat well, sleep well be well! Make sure you are getting lots of rest, and are eating a balanced diet. Avoid simple sugars, and make sure you are getting adequate protein.

Botanical Boost

Depending on presentation, there are a number of botanical medicines that are helpful in the treatment of colds and flu. Some botanicals getting a lot of action in clinic this year include andrographis, echinaccea, ginseng, goldenseal, and elecampane.

For current patients who have had the appropriate lab work done in advance, we offer intravenous vitamin C treatments acutely for colds and flu. This can often have a dramatic impact early in the course of the illness, and patients have reported excellent results.

If you don’t have, or haven’t had a cold/flu this year – great! You can still use the above recommendations to prevent getting sick.  In addition to the above, 120 minutes minimum of moderate exercise per week, as well as a good multi strain probiotic will go a long way to helping you avoid getting sick. For those patients looking for a little more kick in their anti-cold campaign or who may be at higher risk of contracting a cold/flu, I also regularly use intravenous Myer’s cocktails, as well as immune boosting botanicals.

Stay cold and flu free this year!  Happy winter!

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Health and Money – It’s Complicated

If “Health” had a facebook page, it would list its relationship status with “Money” as “It’s complicated”.

It’s no secret – the relationship between health and money exists, and it can be pretty dirty. Whether or not we like it, health is a business! We even talk about healthcare as an industry, we allocate healthcare dollars, and you will even hear about getting the most bang for your healthcare buck.

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As a healthcare practitioner, and small business owner I’m always reminded of the Ross and Rachel type relationship between money and health (for you non-Friends watchers thats code for “complicated”). Balancing the responsibilities of ownership, earning an income, and maintaining a profitable business along with providing the best health outcomes to patients is not easy. The most challenging aspects of private-type healthcare in a public health society is managing patient expectations around value and cost of care. In an ideal world we could all stick to the mantra of “staying out of our patients’ pockets”, or very simply, providing the best care possible without considering the price tag. In reality, this isn’t possible.  Along with presenting patients with clinical options, there is always the influence of cost on patient choices and compliance! When introducing some more expensive therapies to the clinic, and trying to price them appropriately, I again got to thinking about his money-health relationship. When I stopped off to pick up a bottle of hand sanitizer at a local pharmacy giant that shall remain nameless – BAM- I was struck by the money and health balance again!

Why was I in a location providing so-called health products and services looking for hand sanitizer, and having to pass by displays for sales of potato chips, soft drinks, and chocolate bars? Better yet, why would an individual picking up their prescription for metformin (a diabetes medication), or lisinopril (an antihypertensive) be forced to walk through a store actively marketing food products completely contraindicated to their condition? Even more laughable, why was there pamphlets for healthy diet change within visible range of the chip aisle?

The easy answer is “profit”. Profit is not inherently a dirty word, but I think we can agree that healthcare “profiteering” indeed is. Although large retailers jumping on the healthcare bandwagon while also providing products that are the root cause of disease may be clearly guilty of putting profits ahead of health, they are not alone. Some companies offering natural health products and services struggle with this balance, and there are are no shortage of notorious examples of individuals profiteering in the natural health sector.

So how do you protect yourself? How do you know when an individual, business, cause, community, or professional values your dollars more than your health? There is no easy answer. Be an informed consumer, be active in your own health management, and always ask yourself the following:

“Is this person caring for me, or selling to me?”

Perhaps the easiest rule of thumb is if a business is pushing chips and pop, their priority is in your pockets and not in protecting your health.

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Try, Try, Again

In practice I see a large number of patients who are dealing with chronic health issues – issues that have been going on for months, years, even decades.  I am always struck by their perseverance in pursuing better health. The path to better health does not follow a straight line.  Often improvement is gradual, set backs occur, and commitment is challenged.  Dealing with a chronic disease is not unlike learning to skate!

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Original photo from http://www.calgary.ca/CSPS/

When observing a young child learning to skate, at first it seems like a lost cause.  Just standing without any support is a small, albeit important, victory.  Gradually the child (or adult in some cases) progresses to slow forward movement by shuffling of feet.  In the process there are countless falls, and sometimes tears, but the new skater always manages to find his or her way back up and moving forward.  With each waiver, each fall, the skater must re-commit to their path of learning.  Through incremental change, sometimes barely noticeable, improvement occurs, and over time the once flailing, falling, skate-walker, becomes a fluid, flawless skater!

Individuals with chronic disease often follow a similar pattern.  Yes, there are times when improvement is drastic and immediate, but more often improvement is gradual, new challenges must be met, and ongoing hard work needs to be done.  Just like the new skater, an individual seeking treatment for chronic disease needs to constantly re-commit themselves to their treatment plan.  And just like the new skater, the reward for the constant commitment, the falls and the flails, is completely worth it!

Here are three basic things that you can do to re-commit yourself, stay focused on your goals, and increase your success in improving your health.

1. Support

Family, friends, workout buddies, health care providers, coaches, and co-workers are crucial in helping you stay on track.  Pick a select number of people who you can confide in, and who you know are supportive of your journey to better health.  Update them regularly, and plan for them to check in on your progress!

2. Set Small, Achievable Goals

You can’t train for a marathon in a day!  Set realistic, achievable goals to act as progress markers in your journey to better health.  These goals can be as simple as being able to walk one extra block, reducing your blood pressure by 5 points, or sleeping an extra 15 minutes per night.  Set your goal, and check in with your goals regularly!

3. Forgive Yourself

Don’t be too hard on yourself! If you slip up once or twice don’t throw your whole action plan out! Just like the new skater, re-commit after each fall!

 

 

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Truthiness in Coca-Cola’s Advertising – A Calorie is a Calorie?

It is true – if you consume more calories than you burn,you will gain weight. The premise of the new Coca-Cola ad is honest – kind of.  A can of coke will add 160 calories to your daily caloric intake, but is that where the health impacts end?

imagesThe science is pretty clear.  There is a growing body of research linking consumption of sugar-sweetened beverages to obesity, type 2 diabetes, kidney stone formation, attention deficit, and even to increased mortality rates (nice way of saying death).  Not only is the evidence of detrimental effect increasing, but levels of consumption continue to trend upwards.

So why doesn’t a 160 calorie can of Coke have the same health impact as any other 160 calorie snack? One very simple hypothesis is the disconnect between the calorie content in each beverage and the effect on satiety (or feeling of fullness).  Having a can of pop a few hours before dinner, or with your meal is unlikely to make you consume any fewer calories at meal time.  Normally you should feel hunger, consume calories, and experience a hunger decrease.  Unfortunately sugar sweetened beverages don’t provide appetite suppression, so lead to higher overall caloric intake.

There is also good evidence to suggest that ingestion of high glycemic index/glycemic load foods (foods that quickly spike blood sugar and provide large amounts of sugar), lead to fluctuating blood sugar and insulin levels throughout the day, which adversely affect energy levels, immunity, and appetite.

Coca-cola continues its honest messaging by providing a list of low and no-calorie beverages it currently produces.  So is the answer to the sugar-sweetened beverage issue to consume diet options?  The science says no.

Artificial, calorie free sweeteners may decrease caloric content, but long term studies do not show benefits for weight management and even suggest weight gain!  The issue with artificial sweeteners is that they cause a disconnect between caloric intake and food “sweetness”.  Artificial sweeteners trick our bodies into expecting an influx in calories based on taste, but provide no caloric input. Over time, this deception disrupts our bodies association between sweet taste and caloric intake, which leads our bodies to underestimate caloric intake, and over consume.

So skip the sugar-sweetened beverages altogether! Try these tips below to replace your pop and stay hydrated!

  • Add fruit slices (lemons, limes, oranges, watermelon) to a jug of water and keep in the fridge
  • Add cucumber or mint to your water
  • Put chopped up fruit into your ice tray, fill with water, freeze, and add anytime to a glass of water
  • Green Tea! Drink it hot or iced (add a few drops of honey for a little sweetness)

Enjoy and stay healthy!

References

Schulze MB, Manson JE, Ludwig DS, et al. Sugar-Sweetened Beverages, Weight Gain, and Incidence of Type 2 Diabetes in Young and Middle-Aged Women. JAMA.2004;292(8):927-934. doi:10.1001/jama.292.8.927.

Ebbeling CB et al. Effects of Decreasing Sugar-Sweetened Beverage Consumption on Body Weight in Adolescents: A Randomized, Controlled Pilot Study. Pediatrics March 2006; 117:3 673-680; doi:10.1542/peds.2005-0983

Ferraro PM, Taylor EN, Gambaro G, Curhan GC. Soda and Other Beverages and the Risk of Kidney StonesCJASN CJN.11661112; published ahead of print May 15, 2013,doi:10.2215/CJN.11661112

Malik VS et al. Sugar-Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes: A meta-analysis Diabetes Care November 2010 33:2477-2483; published ahead of print August 6, 2010, doi:10.2337/dc10-1079

Wiles NJ, Northstone K, Emmett P, Lewis G. ‘Junk food’ diet and childhood behavioral problems: results from the ALSPAC cohort. Eur J Clin Nutr 2009 Apr;63(4):491-8

Susan E. Swithers, PhD and Terry L. Davidson, PhD,A Role for Sweet Taste: Calorie Predictive Relations in Energy Regulation by Rats,”  Purdue University; Behavioral Neuroscience, Vol. 122, No. 1.

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Eat Like a Bear

As a profession, Naturopathic Doctors think, and talk, a lot about food – omega 3 to 6 ratios, glycemic index and load, inflammatory foods, alkaline diets, healthy fats, paleo diets, complete proteins, are topics as common as the weather in Naturopathic circles. Diet counseling is just as individualized as any other aspect of Naturopathic Medicine, and there is no diet that “fits” everyone.  In order to help someone make healthy changes to their diet, it is important to understand what factors have, and do, influence eating habits.

That brings me to a conversation I had with my wife during one of the beautiful days this past week.  We grabbed a coffee and went for a walk downtown (downtown Chatham, so not a particularly long walk), and got to talking a little bit about food.  Over the past year we have been travelling back and forth to Guyana to spend time with the twin 7-year-old boys that are now members of our family (although not quite back in Canada yet), and my wife had just returned from a 3-week visit at the orphanage.

The children have been raised in a Hindu orphanage, so none of the kids there eat meat products. Their diets consist of lots of fruits, beans, peas, chickpeas, okra, and rice.  As expected they don’t have much input into what they get to eat (although when prompted most of the kids profess a love of macaroni and cheese). They generally eat most of what is put in front of them.

During our conversation my wife noted the variety of foods the kids at the orphanage eat, and how interesting their tastes are compared to our preferences as children.  There are so many cultural, social, and economic influences. It seems so much simpler in nature.  My wife had what I thought was a very accurate way of summing up the challenge around factors influencing food choices.  She said,

“A mother bear shows her cubs what to eat to survive, and there is really no other influence on their diet. In nature its such a simple system.”

After joking about how Naturopathicky that sounded, it really got me to thinking more about the challenge of eating well. We all have so many important variables impacting our diets.  Early in life our parents or caregivers play a pivotal role in all of our food choices and set the stage for our lifetime eating habits. The role family tradition plays in diet, whether its recipes handed down through generations or habits fostered by years of dietary repetition, is undoubtedly large, but may be shrinking.  Powerful advertisements, convenience foods, even the term “engineered food”, only recently became norms in human history.  A mother bear may have to deal with food availability at times, but she never has to worry about vending machines, advertising directed at youth, convenience foods, or foods engineered to become addictive.

With all of the complex advice out there, it is easy to loose sight of the big picture.  Food is meant to be life sustaining, enjoyable, and health promoting.  The first step to pursuing a more healthful diet is identifying what factors in your life are influencing your dietary choices.  When making your own food choices, or choices for your family, think of yourself as mother bear.  Choose foods that are nourishing, close to nature, and promote health.  Next time you turn down a food you don’t like, or are craving your favorite snack, take some time to think about how you came to view those foods the way you do.  A healthy change in how we relate to food is the first step in making better dietary choices, taking a preventative approach to wellness, and improving health.

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What is Naturopathic Medicine, Naturopathy, Alternative Medicine, Complimentary Medicine …..

While speaking to the Chatham Rotary Club a few weeks ago, I mentioned I spend a lot of time discussing just what Naturopathic Medicine is, what we as Naturopathic Doctors do, and how I think our practice philosophy can help patients achieve greater health.  More recently, I spoke with a local Medical Doctor over a cup of coffee and we discussed at length what we thought Family Medicine and Naturopathic Medicine should mean. When asked “what is Naturopathic Medicine” I often rely on a short elevator speech I have prepared, and I have another reliable intro I give to new patients regarding what to expect as we work together, but beyond that I think there is a lot more to define when it comes to Naturopathic Medicine – or maybe there isn’t.

About-naturopathyI am unsure of where I first ran into the concept of stripping away the definition of alternative medicine, but I really think that there is only “medicine that works, and medicine that doesn’t work”.  The labels alternative, complimentary, etc, do help us to roughly define a “different” system in which medicine is practiced, but I think at times they are used to question legitimacy, or imply a less rigorous evaluation of some medical diagnostics or therapeutics.

Personally I am trying to redefine how I speak about Naturopathic Medicine.  As a system or style of practice the philosophy speaks to the major commonalities between practitioners in our profession – treating the whole person, doctor as teacher, and treating the fundamental cause of disease.  I also think these are tenants important in “good medicine”, and should not remain unique to Naturopathic Doctors.  Plenty of Medical Doctors, Chiropractors, Physiotherapists, Social Workers, Dentists, and others are involved in evaluating and addressing the social determinants of health, the individual nature of disease, and the importance in teaching as part of healthcare.  There are lots of individuals practicing “good medicine” in different ways.

The next time I am asked “What is Naturopathic Medicine?” I am going to be much more thoughtful in my response.  Naturopathic Doctors practice medicine.  We address health concerns, health promotion, and disease prevention through individualized medical approaches rooted in evidence based medicine and clinical experience.

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