Final Blog Post

After 4 years of giving this blog writing a whirl, I've decided to wrap it up this year. My intention of this blog was to pay tribute to my father, as well as to communicate with friends and family in a unique way by writing these posts.  Going into this, I knew that I wasn't much of a writer, but I did want to connect in this different way of expression.  I'm moving on, and found that I prefer connecting over the phone or in person, where I can see the person, hear the person, or hug the person.  I prefer more intimate connections than what a blog can provide for me;  and both take time.  I prefer to spend my personal time in ways that I find more life-enhancing.

My new website will be geared solely toward my career, with a blog geared toward valuable information that I will share with my patients and community.

As far as my tribute to both of my parents, I hope I have done them justice, and may they both rest in peace.

I love you mom and dad.  I still miss you.

Hilary Graham, R.Ac

hil grad 4 copy My daughter graduated from the acupuncture program in Nelson, B.C. this past weekend.

Her knowledge of Chinese medicine and acupuncture has already helped many of our family members including myself.

She continues onward with excitement and passion toward obtaining her R.TCM.P designation (Registered Traditional Chinese Medicine Practitioner).

Beautiful as ever.  Smart as ever. Enthusiastic as ever.

Congratulations and good luck Hilary!!

 

Suicide

thYeah, I know.  Depressing topic, but an important one. This afternoon I was going to attend a memorial for a person whom I didn't know and who committed suicide.  I wanted to attend in order to be supportive to the person whom I did know and who cared for this individual.

I changed my mind about attending and thought I could be more helpful by writing this blog.

Tens of thousands of people from around the world read my blog.  I'm not sure why.  I basically write this blog for a handful of my family members and friends.  However, the internet being what it is, and to the many of you who browse my blog, this is what I have to say to anyone thinking of taking their own life right now:

Hang in there.  Please.

You're not alone in your despair.  I get it.  I completely understand what it feels like to believe you are at the end of your rope with no hope of anything ever getting any better and wanting the emotional pain to end.  I understand your thought process along with your agonizing feelings that allow you to think that suicide is the only curative solution for your pain.  I get it.

Many moons ago, I too were where you are now;  feeling trapped in a maze with no way out;  experiencing heart-wrenching, emotional, never-ending pain;  being swallowed up in sadness and eternal suffering;  and wanting it all to end, once and for all.

Please.  Hang in there.

Just because you cannot see any answers now, doesn't mean they don't exist.  You are unique.  You are important.  You just haven't found your answers yet that will be most helpful for you at this particular moment in time.  There is always hope.  Always, in all ways.

You will get out of this maze of suffering.  Be patient.  Wait.  Be still.  Breathe.  Deeply breathe.  I am praying for you right now, that you will wait long enough to be able to find your answers.

Finding your way out of your maze is uniquely your experience.  One size does not fit all.  There are many ways I have seen, both professionally and personally, that have helped people find a way out, without committing suicide.

Please, wait.

Perhaps you have an undiagnosed physical condition like hypothyroidism for example, that is easily amendable with treatment.

Perhaps you have tried a multitude of pharmaceutical medications but have been misdiagnosed, and instead have a condition like Bipolar for example, and the correct pharmaceutical medication will make all of the difference in your life.

Perhaps you have tried a multitude of pharmaceutical medications, but have not yet explored Dr. Marty Hinz' work on Relative Nutritional Deficiencies and brain chemistry.

Perhaps you have tried changing your diet, but have not yet explored completely eliminating grains from your diet that for some people, can create a dramatic improvement in brain function.

Perhaps you are going through a huge transition time in your life like puberty or menopause and need hormonal support.

Perhaps you are a physician who is contemplating suicide.  If so, please contact this angel ASAP:  Dr. Pamela Wible MD.

Perhaps you have experienced challenging life traumas in your past and have not yet come across tools and perspectives that facilitate self-kindness in an ongoing way.

Perhaps you are judging your feelings and have not yet learned how to embrace all of your feelings, including the tough ones like sadness, anger and fear.  We live in a society where there is an underlying current of unacceptability regarding "negative" emotions.  Emotions are beautiful.  Expressed and unexpressed.  They are what what make you human.  Embrace this part of your humanity.  Allow your emotions to just be, without judging or resisting them.  In this way, letting go becomes a constant expression of finding the exquisite kindness to yourself that you are likely seeking.

Perhaps you believe you have tried everything and nothing has worked.  Sweet, dear, person who is reading this:  this simply is not true.  What you have tried is only the tip of the iceberg of all that is available to you.  There is so much more that you have not explored than what you have already explored.  The journey is the search and it is not elusive.

Perhaps the solution to your dilemma is just around the corner and what you must muster right here and right now, is divine patience.  Just beautiful, beautiful, waiting.

Perhaps . . .

Perhaps . . .

Perhaps . . .

So many possibilities, so many different mazes, so many different solutions.

Perhaps you believe that you are alone.  You are never alone.

BC Crisis Centre

Suicide Prevention 

Hang in there, please, hang in there.

The world will look different in a little while.  Change is never-ending.  The despair you are now feeling will also change.  I promise.

Love Kathy

In Honour of Mom

Panayiota (Jan. 26, 1931 - Mar. 31, 1999) Her long form English name was Patricia.  Canadians called her Pat;  it was Mrs. Savich, to the younger ones that loved her.  Her long form Greek name was Panayiota, and Pota for short.

She was an enthusiastic ball of affection, who took no guff from anyone, and had arms wide enough for everyone.  She was devoted, passionate, feisty and above all, loving.  She rode a roller coaster of emotional highs and lows most of her life, always (and unnecessarily), apologizing for this sweet and precious aspect of her humanity.

She was simply, beautiful.  On her tomb stone it reads, "Compassionate, Beautiful, Indomitable Soul".

She would have been 84 this year had she miraculously survived ALS.  In 2 months, it will be the 16th anniversary of her death.  And like every year, donating to ALS groups and to pALS is what I do to honour her memory.  I've blogged about this disease extensively.

This year, I wanted to do something a bit different.  I wanted to share with you, my family and friends, (and perhaps strangers that wandered on to this blog), songs that I had written almost 2 decades ago while mom was dying.

Grief brings out the most creative impulses.  Actually, writing these songs was therapy for me at that time.  Music heals in profound ways, and writing these songs was a way I desperately tried to come to terms with her dying process.  At that time, I was losing the most incredible, loving and sweetest woman I had ever known.

I wrote over 30 songs, 3 of which were recorded.  It wasn't done professionally or anything.  After all, it was me playing the synthesizer/piano;  definitely very amateurish.  The recordings are kind of scratchy.  However, I was very, very lucky to get Gail Jenne, an exquisite Bulkley Valley songstress, to sing these songs.  Her daughter Taisa provided some of the harmonies.  I am indebted to them.  Thank you Gail and Taisa.

1.  Questions

This is a song I wrote, questioning the topic of death.  When was I suppose to hold on?  When was I suppose to let go?

Here are the words:  Questions

2.  An Angel Sat Down On My Bed

This is a song I wrote to comfort myself.  I wanted to believe that while mom journeyed toward death, she would find great comfort.

Here are the words:  An Angel Sat Down On My Bed

3.  Goodbye

This is a song I wrote when I knew that mom and I would have to part ways soon.

Here are the words:  Goodbye

I don't know how it works in the afterlife or if there even is one.  Some people claim that they know.  I don't.  However, I do know that our Spirit is eternal and I know that right in this present moment, mom lives in my heart, and that too, is eternal.

I love you.

EDITED TO ADD (Jan. 31/15):

Thank you so much for your responses to this blog, whether to me personally, or directly on this blog.  I'm blown away by your responses.  Much, much gratitude.

Paul Dwyer is a musician extraordinaire, and he finished writing a song after his friend died.  It is called "What a Day".

Take a listen.  I can actually feel my heart opening wider and wider and wider as more and more harmonies enter the song.  Beautiful!  Thanks Paul.  (You can click on the link above to hear it, or down below, where it's easier to see it).

Peter Savich is my brother, and he wrote a most moving tribute to mom 4 days after she died.  It is called, In Loving Memory of a Singular Woman.  And as I read it now again, after so long, I am filled with amazement at his raw honesty during a very challenging time in his life.  I am also filled with gratitude for his gift to his "church", and wanting to memorialize mom through gifting to the most important aspects of his life:  family and friends.  Thanks Pete.

EDITED TO ADD (Feb. 1/15)

Thanks also goes to Richard Jenne who recorded these 3 songs and compiled the instrumentation and vocals.

Please Donate to Baby Kelel

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63520smithersbrotherDominick-WEB

I write this One Size Does Not Fit All website for my family and friends.  So when Wordpress.com sent me my annual blogger report for 2014, I was surprised to see that my website had been viewed 9800 times last year.  I only have a few handfuls of family members and friends. I'm a bottom line person so I'll cut right to the chase.  I'd like whoever is reading this blog to donate money to this infant and his family.  Imagine.  If all 9800 views resulted in a $10 donation, that would be close to $100K.  Obviously, most of the people that read my blog are fly-by-nighters who don't get much out of reading my boring personal life stories, along with information that I write mostly for my own posterity.  They are people who probably just straggled onto my website inadvertently.

However, then there are folks like YOU, who read my stuff just because it's me :), or you may be someone I've never met before but have a big heart.

Please take a read at Kelel's story written by Chris Gareau.

If you live in town (i.e. the Bulkley Valley area), you can donate whatever you like at the Bulkley Valley Credit Union to Account #430447 for Joe and Tammy.

If you live out of town, you can send a cheque to the:

Bulkley Valley Credit Union, 3894 1st Ave., Smithers, B.C., Canada, V0J 2N0, made out to Joe and Tammy, Account #430447.

If you too are moved by Kelel's story, please pass his story on.  Thanks!

Now that I've addressed the most important part of this blog, the much less important and boring personal part about why this story has touched me so deeply, consumes the rest of this blog entry.

Kelel has SMA (spinal muscular atrophy); Type I in fact, which is the worst form of this disease.  SMA is probably one of the worst diseases on the planet, that is, if "worst" is defined to mean "extraordinarily challenging".  I used to call ALS the "worst" disease on the planet, now more famously known as the ALS ice bucket challenge disease.  I have always given ALS a "worst" hierarchical designation, not just because my mom had it, but I truly couldn't imagine a disease more limiting than one that prevented a person from moving, speaking, eating, and even breathing without mechanical support, all of the while, being cognizant of everything occurring around the individual.

Well, SMA supersedes the "worst" by definition for me.  Why?  Because we're not talking about older people, or even young adults, which is bad enough.  We are talking about a baby that started out in the world with so many losses to begin with.  As with ALS, there is no cure for SMA . . .  yet.  Hopefully, the present that is riddled with unknown answers, will turn into a future that carries viable and effective solutions.

SMA is like an infant having ALS.  They aren't the same disease by a long stretch, but their similarities are hard to miss and enormously sad.  Both diseases affect the anterior horn of the spinal cord, which is where motor neurons live.  In these particular illnesses, the anterior horn is also where motor neurons die, rendering people afflicted with SMA and ALS completely incapacitated.

Yes, there are super heroes in this world who have SMA and ALS.  I bow to these people and I would kiss their feet if I were in their physical presence.  These folks have a kind of magnanimous internal strength that flies in the face of their overwhelming incapacity, and a type of fortitude and drive that I have not witnessed in able-bodied individuals.  Their stories are incredibly mind blowing.  Here are a few:

Mike Phillips has SMA, and with minimal thumb movement, writes a creative blog called My Whole Expanse I Cannot See.  This is his story from This American Life created by Ira Glass (and also co-produced by Sarah Koenig of Serial podcast fame):

Another super hero is Eric Valor and he has ALS.  With only the movement of his eyes, he has developed a non-profit biotech company that tests potential molecules on mice in hopes that the substance will turn out to be a viable treatment for this (presently) incurable disease:

J147:  Therapeutic for ALS

Do I know baby Kelel?  No.  I have never met Kelel or his family.  I was just deeply touched by the well written article in my community newspaper by Gareau.

What is my interest in baby Kelel?  Well, we all have our own crosses to bear;  some not so heavy, and some really heavy.  I suppose it's all relative, as well as a matter of perspective.  From my point of view, with the experience of helping care for my mom in the last weeks of her life, and with my previous medical experience as an NICU nurse, I cannot even fathom the weight of the cross this family must bear.  Sonia Lester wrote a beautiful letter to the editor about the understated struggles of this family and the great love and support that surrounds Kelel:  his parents, his sibling, his stellar pediatrician (Claire Moisey rocks!), family friends, and church members.

And even though love will outweigh every possible heavy burden every time, like Simon of Cyrene, this cross would be lighter with many helping hands.

Please donate.

Thanks.

Agape: Happy Anniversary

Bill,

This blog is for you.

August 27th, 1983 was the most important day of my life, because it was the celebration of the most important commitment in my life.

That day, the minister talked about agape; quite fitting that it is a Greek word. He spoke about agape in a religious context, referring to God's love being an unconditional love.

A wedding is a public declaration of love and commitment, supported and celebrated by a community of family and friends who love us. This loving community of family and friends continued to support our union not only on our wedding day, but also during the years that followed. Along with our agape vows, when I look back at that day over thirty years ago, many of those in our loving community are no longer with us. In this video clip are people who have loved us, and whom we have loved and lost:

When I look at how far we have come, I well up with tremendous gratitude. Thank you for sharing with me all of my joys. Thank you for always being in my corner, even when you didn't agree with me at times. Thank you for seeing and knowing all of my flaws and loving me in spite of them. Thank you for loving me during the easy times, and I especially thank you for loving me during the hard times. Thank you for being my soft place to fall and my strong rock to lean on when I needed it most. Thank you for your unconditionality. Thank you for your agape.

I don't consider myself to be a religious or spiritual person. I'm a lukewarm agnostic who revels in sacred ritual, sacred traditions and open-hearted sentimentality. I completely understand both the fervent atheist and the devout believer, as well as everyone in between. Like so many, I sit on the spiritual fence with arms wide open to the universe and creation, exclaiming, "I don't know".

However, in my lifetime, the closest thing I have ever come to having proof that God actually exists, is my experience of your love and presence in my life.

Thank you for loving me so.  Happy anniversary sweetheart.

Kathy

PS I pray that my body will never see a tattoo.   ;)

Numbers Needed To Treat Or To Harm

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images

When it comes to medicine, I would hazard a guess to say that almost every patient I have ever seen has never heard of this concept. As well, I would guess that almost every non-medical friend and family member of mine, does not understand these very important facts. NNTs (Numbers Needed To Treat) and NNHs (Numbers Needed To Harm) are the most important numbers in the world of scientific medicine for clinical relevancy. Concerning your health and medical treatment, they are fabulous guidelines to make wise decisions from.

You know how some breaking news stories will exclaim, "Treatment X decreases the risk of Disease A by 50%!!!"  Not to mention, "40% of the time, Drug Z is effective for curing Condition B!!!"

I mean, doesn't that sound mighty impressive?!?! Hell, if that were really true, I'd be waiting in line for Treatment X and Drug Z.

But alas, what these news stories give you, are RRRs (Relative Risk Reductions), not the all important ARRs (Absolute Risk Reductions).  And like Dr. James McCormack's music video in my previous blog sings out, "Relative numbers they can wait, I want absolute numbers on my plate".

I'll break it down by giving you a simplistic example.

There are 100 people in a study that have Condition B. They are randomly selected and are given Drug Z. Both they, and their nurse, do not know whether they are receiving just a sugar pill (placebo) or Drug Z.

There are also 100 other people in this same study that have Condition B. They are also randomly selected and are given a sugar pill instead of Drug Z. They don't know they are getting the placebo and neither does their nurse.

At the conclusion of the study after all of the number crunching is in, it is determined that 2 people out of 100 from the Drug Z group have experienced a cure in their condition. It is also determined that 1 person out of 100 from the placebo group has also experienced a cure in his condition.

2 cures (Drug Z group) as compared to 1 cure (placebo group), whoa! That's a 50% RRR. Pretty potent drug, huh?  Not quite.

If we could dip into quantum mechanics and be in two different places at the same time, then the 'you' who is taking the drug is twice as lucky to get cured as the 'you' who is taking the placebo.  But since humans can't be in two places at the same time, the relative meaning in Relative Risk Reduction is meaningless.

A more meaningful way of looking at this data, is that the Absolute Risk Reduction (ARR) will tell you that only 2% of the people in the Drug Z group were cured as compared to the 1% in the placebo group. That's a reduction of a big whopping 1%.

Can you imagine THESE headlines?  "1% of the time, Drug Z is effective in curing Condition B."

If Condition B was a terminally fatal disease that had no known cure, even 1% would be impressive. However, for other non-life threatening conditions, 1% is not impressive. The NNT in this case would be 1. What this means, is that 100 people would have to take Drug Z in order for only 1 person to benefit from it.  In other words, of 99 other people taking Drug Z, how lucky do you think that you would be the one being cured?

That's the NNT part of the story.

The other part of the story, is that in this same study, 5 out of the 100 people taking Drug Z experienced severe side effects. In the placebo group, only 2 out of the 100 people experienced severe side effects.

That means that 3% of people taking Drug Z experienced severe side effects. For every 33 people taking Drug Z, 1 will have a severe side effect and this is the Number Needed To Harm (NNH).  In other words, of 32 other people taking Drug Z, how unlucky do you think that you would be the one person experiencing severe side effects?

As mentioned, depending on the condition, taking a shot at having a chance of 1% benefit with a 3% risk of severe side effects might be a wise move. For other conditions, the benefit:risk ratio would be abysmal. This is evidence-based medicine.

I've been wanting to write this blog for a long time now, but what got me off my butt to write it, is a comment I have heard going around this town for over a decade now. I admit, it's second hand information so I did not hear this directly from the specialist himself. However, over the years, I would say that I have heard some version of this comment from over 50 women. It goes like this:

"Every woman should be on the birth control pill or HRT. I would put all of the women in my family on this."

Well, you know me.

I'm a big proponent of ONE SIZE DOES NOT FIT ALL. But the last time I heard a female patient say some version of this comment to me, that was the last straw. I just had to look at the data that made this specialist so sure that every human being with a vagina and boobs needed their daily regular dose of oral contraceptives.

Make no mistake. Oral contraceptives (OC) are a phenomenal therapy for so many reasons, including fertility control and dysfunctional uterine bleeding absent gynaecological pathology, to name a minuscule few.

I presumed the impetus of this specialist's statements was based on the idea that OCs prevent ovarian cancer (an often deadly cancer because it is often diagnosed in its later stages), endometrial cancer and colorectal cancer.

I looked at the data. Not impressive.

At first blush, in this study, one of the data points states that the RRR for ovarian cancer prevention, is that 50% of women will be spared this horrible disease if they use OCs for 15 years. But we already know about RRRs, don't we?

However, when you get down to the nitty gritty and look at the data, it's not as jaw dropping as a 50% RRR. The NNTs go like this:  500 women need to take OCs for 10 years in order that there will be 1 woman who will benefit from the prevention of an ovarian cancer death.  And 250 women need to take OCs for 10 years in order that 1 woman will benefit from the prevention of ovarian cancer.

Now, if a woman is taking OCs for a darn good reason anyway, this information is just possible bonus protection.  If she has a family history of ovarian cancer, it may be an excellent consideration to start taking OCs.

But for every woman to take OCs carte blanche for the prevention of ovarian and endometrial cancers . . . well, the science is not super robust for that kind of ONE SIZE FITS ALL mentality.

Not to mention, there are rare risks to taking OCs like VT (with rare fatalities) and a negligible increased risk in breast cancer.

Every woman is unique. Every woman is different. And every woman deserves medicine that is not shaped in a cookie cutter type of fashion.

Along with OCs, (that I do not prescribe carte blanche), I also do not prescribe multi vitamins carte blanche, because I have looked at the data. The most hilarious commentary based on the science (NNTs) of multi vitamin consumption was co-authored by Dr. McCormack. Take a read. It left me rolling on the floor:

Sure Fire Tricks To Get The Most Out Of Your Vitamin Supplements

In order to determine if a drug or treatment that is prescribed for you is in your best interest, an excellent (but very incomplete) website to start with is called The NNT.

As my favourite video of all time sings out:

"Clinical evidence is the maxim, NNTs are now my passion".

Medical Misfit or Free Agent

I used to be a medical misfit.

After a combined almost 40 years in healthcare, nursing and medical practice, I indeed used to think that I was a medical misfit. In the past, when I attended conventional medical conferences, I always had this sense that I didn't "fit" in. When I attended naturopathic or alternative medical conferences, I also had this sense that I didn't "fit" in. It used to bother me. It no longer does because I have changed my perspective. I'm not a misfit anymore, I'm a free agent now.

Both the religiosity of science and the religiosity of nature philosophy, for me, never trumped that which was most important and most effective for the patient.

I have always had one bottom line with my approach to medicine: help the patient maximally, with a best guess at the most minimal risk possible. Any assessment of risk will always be a best guess, even when good science or good common sense guides the decision-making processes. This is because one size does not fit all.

In my free agent status, these are the most important aspects in my approach to medicine:

  • EBM (Evidence Based Medicine) as per Dr. James McCormack PhD. I LOVE this guy's stuff:

 

Numbers Needed To Treat and Numbers Needed To Harm as per The NNT, looking at all of the scientific studies with a discerning eye from a viewpoint of clinical relevancy. Without looking at this data, science-based medicine has diminished use.

  • One Size Does Not Fit All. Other than the fact that we all change and we all die, it's the only other truth I know for sure.

I like being a free agent and I'm not about to sign up anywhere just yet . . . if ever.

Do We Benefit From the Death of Our Parents?

DSCN0915This is not a blog about financial inheritance. This is a blog in response to my brother's piece entitled, “When Our Parent's Kick The Bucket”. He writes about the emotional maturity, wisdom, grace and “enlightenment” we can obtain if our parents died early enough at a time in our lives that we could potentially benefit from their demise.

The first time I read his blog, I cried. I cried because anytime someone talks about how incredible our parents were, I'm moved in ways beyond articulation. As well, I liked the idea that I could somehow personally benefit from an experience of grief, like fertilizer for an anticipated bloom; the possible notion that my grief was for some better purpose.

I told him I would comment on his blog after I had come back from a visit with mom and dad out east.

DSCN0918At the Woodland cemetery in Kitchener, Ontario, the tombstone had been overgrown with thorny rose bush stems after an Ontario winter, waiting until warmer weather for my sister to prune these lovely plants in order to reveal its hidden inscriptions:

Душан 14 - 9 - 1926 9 - 12 - 2010 Cкро̏ман (meaning humble, modest, unassuming)

Παναγιωτα 26 - 1 - 1931 31 - 3 - 1999 Beautiful, Compassionate, Indomitable Soul

I stood there looking at their tombstone in the cool morning sunlight, and wondered if I had actually benefited from their deaths in a maturing-kind of way; that their deaths had somehow transformed my life with grace and wisdom.

Nope.

Staring at the tombstone in front of me, I asked my parents, as I've asked myself many times before (as far back as I can remember), “What's it all about anyway?”

I cried for five minutes, and then I reflected on the question for twenty minutes after that.

There exists no one truth to the answer for that question, except through the unique eyes and perceptions of the one who is looking and asking at any particular moment.

For me, life is about the ongoing cycles and continuing movement between heartbreak and gratitude. When I use the word heartbreak, I mean it to comprise all types of intensities from miniscule fleeting disappointment, to prolonged heart wrenching loss and everything in between. At the core of heartbreak lies the notion of survival and the act of holding on. When I use the word gratitude, I mean it to comprise all types of intensities, from quiet peaceful contentment, to unbridled joyous love and everything in between. At the core of gratitude lies the notion of surrender and the act of letting go.

Heartbreak then gratitude, then heartbreak then gratitude once again, and the cycle continues until our last train stop home. Loss then gain, then loss then gain once again, and the cycle continues until our heart stops beating, leaving those behind to wonder about the meaning of our physical loss in their own lives. We enter this world holding on to life, then go through the cycles of letting go and holding on, over and over and over again, until we completely let go into our last breath.

To each unique individual on the planet, the ultimate purpose of these cycles may be about connection, or about love, or about acceptance, or about trust, or about learning. For others, these cycles have no ultimate purpose except to have experienced the experience. One size does not fit all.

We can allow unhindered movement in going from one experience to the next, through tears and sighs that can be the bridge between heartbreak and gratitude, between holding on and letting go, that can ease the transition along the way. Tears and sighs are like rain showers and wind gusts, clearing the path and making way for the next experience to follow. Without the rain and wind, we become stiff. My brother's theory of aging is as follows: “it amounts to stiffening – stiffening of our arteries, our joints, our hearts, our minds, etc.” Sighs are the gusts of comfort, and tears are the lubricant to our stiffening.

At every stage of life we have the opportunity to accept the endless flow of these vacillating states. We can do this while our parents are alive or when they die. Our parents' dying need not be a motivating force for change or for growth at any age.

This past weekend, my husband and I flew across the country to see his elderly mother and father for their 78th and 80th birthdays respectively. They were more frail, both physically and mentally than we had seen them in years past. My husband spent his short time with them, laughing at memories gone by, hugging them with gratitude, and crying while sharing with them, their losses and struggles as they both experienced the challenges of advancing age and illness. Rain had cleared the path once again.

Throughout their lives, both my mom and dad would say this: “Forget about it, it's not important”. It was their way of helping each other and helping their children remember to transition from holding on to letting go; from heartbreak to gratitude; from perceived loss to perceived gain; knowing that these cycles are ongoing until we breathe our last breath. This is the way I articulate this concept: “Life is too short to withhold an open mind and an open heart.”

So do we benefit from the death of our parents? Yes, for some, like my brother, whose humanity exponentiated after my mother's death. No, for others like me, who plod along through life, hopping on and off that train before the last stop called death, in a constant flux between holding on and letting go, and trying to embrace all of it; both the heartbreaks and the gratitudes.

And in so doing, my losses and heartbreaks become more deeply bittersweet, and my gains and gratitudes become more richly expansive.

The Art of Medicine

http://www.youtube.com/watch?v=5cvHgGM-cRI

Actually, I could have called this blog "Dr. Pamela Wible MD", and it would have been just as accurate.

Dr. Wible is a general family physician practicing in Oregon, who, along with her TED talk, has also written a book called 'Pet Goats and Pap Smears'.

Every physician must read this book, for their own health and humanity.

Every patient must read this book, so that they can give it to their own physicians.

Pamela is the extremely feminine version of a cross between Patch Adams, Bernie Siegel and Seinfeld's Kramer.  She is an incredible mix of zany, hilarious, beyond loving, and real;  I mean really real.  Her unique authenticity is unparalleled in any health practitioner I have ever come across in person or in written word.

This book is worth getting just for reading the section alone, entitled "My favourite phone message".  When I reread it even now, I still laugh.

The true stories in this book are filled with compassion, laughter, sadness and most of all, loving authenticity.  As I watched the TED talk and read her book, it was so very clear to me that the relationship Pamela has with her patients and the physicians she supports, is built on profound trust and love.  The flavour of the medicine she delivers to her patients, and the lifeline she extends to her colleagues, comes with the added bonus of this slightly altered 1 Corninthians 13 verse:  Love is patient, love is kind, it does not envy, it does not boast, it is not proud, it does not dishonour others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs, it rejoices with the truth, it always protects, always trusts, always hopes, always perseveres, never fails, - and is creatively zany.

I remember going through naturopathic medical school, and a classmate verbosely marveled at how there was such an incredible creativity to the art and practice of medicine.  Frankly, back then, I didn't see it at all.  Twenty-five years later, I still didn't see it, until I saw and read Pamela Wible in action.  From the gift-basket offerings she gives out if she is late for patient appointments, - to balloons and lipstick kisses just-because, - to pap smear parties, - and to even the contemplation of a clinic pet goat, - after learning about her, I had a change of heart in the way I saw the possibilities for creativity in the practice of medicine.

While I can't say that I have ever brought any profound creativity in my approach to medicine over the years, I am blessed that there have been many patients who have trusted me enough to have brought their own brand of creativity and laughter to my practice.

Many years back, I was almost rolling on the clinic floor with laughter.  So the story goes:  I'm administering intravenous therapies to a room full of patients.  While I'm taking the blood pressure of an older gentleman, he whispers to me in a serious tone, "Kathy, I think you'd better go and check your bathroom".  With a concerned look on my face, I quickly make my way to the bathroom.  There, I see a huge pile of poo on the floor beside the toilet.  My brain is racing a million miles an hour.  OMG.  Which patient did that?  Is he or she that sick and missed the toilet?  I quickly do an internal mental scan:  everyone's vitals are good, everyone's level of consciousness is good, no one has any disconcerting symptoms.  Who the heck did that?  I am worried sick and I quietly remain in the bathroom trying to figure this out.  I decide to clean the mess up before I head back to the treatment room.  Donning my latex gloves, I proceed to pick up the poo with paper towels.  Immediately upon lifting the feces, I realize that it's a realistic plastic dog poo replica.  The joke is on me, and when I start to laugh, the entire treatment room breaks out in laughter.  The older gentleman says that when he saw the plastic replica on his trip to Las Vegas the month before, he thought of me.  As funny as that sounds, I saw this as an incredible compliment to how comfortable he felt with me in order to have played his practical joke.  All of the other patients, after their raucous laughter and being in on the joke, were feeling exceptionally well.  I'm sure that it had little to do with what was infusing in their IV bags that day.

Creativity isn't the only reason I am enamoured with Dr. Wilbe's work.  Her authenticity is mesmerizing.  In Pet Goats & Pap Smears, there is a section called "The Raw Truth".  In it, Pamela queries why she is a doctor.  These are the most honest and profound words I have ever read, coming from a healthcare practitioner.  Buy the book and read it.  You will be amazed.

In trying to answer for myself the question of why I am a doctor, I wonder if I will ever come close to expressing a fraction of the authenticity exuded by Dr. Pamela in "The Raw Truth".  Beyond my reasoning for having entered the field of naturopathic medicine in the first place, I suppose I would say that I continue to practice medicine because of my belief in the best quality of life for all people, including myself.  I'm pretty much a bottom line person, focused on patient outcomes, wellness, well-being and the success or failure of those, no matter the type of treatment administered.  I am not married to a particular medical philosophy, science-based, or otherwise.  I am married to the idea of the best quality and longevity of life possible, that any type of medicine can offer.  Failure of treatment is what initially led me to explore naturopathic medicine, after having been steeped in conventional modalities for a decade previous to that.  And later on, failure (and lack) of treatment for my mom who died of ALS, at times, still breaks my heart to this very day.  And now, failure of treatment in the occasional patient who has sought out every form of medicine on the planet to no avail, and then has landed on my doorstep with hopes that I cannot fulfill, leaves me empty.  I am a doctor who has not yet realized what Dr. Pamela Wilbe knows to be true:  that medicine and healing are a journey and not endpoints.  She has learned, preached and written about, what I long to learn in medicine:  that sometimes love is enough.  People die, people become ill, people are in pain, and occasionally, there is nothing anyone can do about it.  In these cases, love has to be enough.  I'm not there yet.  I'm still traveling that road.

I can't leave this blog without mentioning the section in her book called "Bambi Syndrome".  As a new born-again dog lover, I cried while reading this chapter.  To my 2 friends who are the most stellar dog owners in the entire universe, Pamela rivals your commitment to man's best friend.  You both have to get this book just to read this chapter!

For me, Pamela serves as a model for the practice of medicine.  While I have no pet goats, I do have a very cute goldendoodle that looks like a sheep and comes with me to the office each time I'm there.  And I stopped doing PAP smears decades ago when I realized that it was more affordable for patients to let the Canadian government pay for this type of screening done by MDs than to pay an out of pocket expense to me.  I do however, ensure that all women are up to date with their PAPs, and for those women who "do not believe in PAPs", I counsel them for up to an hour at times;  - some women have a change of heart and some do not.

Medicine is replete with science and necessarily so.  Medicine can also be replete with humanity.

If there was a Nobel Prize for Loving Authenticity in Medicine, Dr. Pamela Wible MD would be a shoe in.

 

ALS Treatments Part 4

 March 31st of this year will be the 15th anniversary of my mom's death. ALS took her life. It is a despicable disease. I've written about it for the past 2 years, here, here, here, here, and here.

I write this blog, - especially this ALS blog – for my family. In the (unlikely) event my maternal grandmother was misdiagnosed and she actually had ALS, I want my loved ones to know what is happening in the world of ALS. By keeping up to date with information, I honour my mother and I honour my family.

Even though this is a personal blog that I write, I am surprised to see people in 144 different countries from around the world click on to my website. I do not advertise my blog since it is a personal one. As of this writing, there have been 1004 views for the ALS Treatments Part 3 blog, 928 views for the ALS: A Tough Road blog, 666 views for the ALS Treatments Part 2 blog, and 507 views for the ALS Treatments Part 1 blog. When I see this, I am sad.

I am sad, because it means that if pALS and cALS ended up here reading this blog, it likely means that they are desperate for information. I know the feeling. My heart goes out to all who read this.

The best review of ALS treatments in 2013 can be found here:

http://blogs.als.net/post/2014/01/15/ALS-2013-A-Year-in-Review.aspx

Not much is new.

For those that believe in the scientific process and would like to donate their lives to this cause, there are numerous clinical trials to participate in from around the world.  They consist of pretty much the same things for the past while now: stem cells, immunosuppressants, immunomodulators, an irreversible MAO inhibitor, a monoclonal antibody, a tyrosine-kinase inhibitor, yada, yada, yada:

http://www.als.net/ALS-Research/ALS-Clinical-Trials/

Neuralstem's poster boy, Mr. Ted Harada, gives pALS hope with the very delicate intraspinal stem cell procedure he has received twice now:

http://www.totalbiopharma.com/2013/12/09/video-ted-harada-als-patient-perspective-stem-cells-regenerative-medicine-congress-2013/

However, neurologist Dr. Jonathon Glass, expressed a more realistic view of hope, and stated that this particular stem cell procedure would hopefully help patients decline less rapidly:

http://www.youtube.com/watch?v=zMQISB5iL-g

This stem cell trial as well as other stem cell trials using intrathecal mesenchyal stem cells are only in Phase II clinical trials right now. It is still early yet to know the outcomes. Either patients and researchers are keeping the results hush-hush, or there are no more poster boys to be found in these scientific studies, and the best that is now hoped for, is a slow demise rather than a rapid one.

If the goal is slow progression, there are umpteen anecdotes in pALS who have come up with their own supplement cocktail to try and stave off deterioration in order to create a slow demise rather than a rapid one for themselves. The difference between the scientific approach of clinical stem cell trials or drugs, and an experimental cocktail attempted by separate individuals, lies in the notion of “proof”. In a disease where the progression is highly variable from person to person, and the powerful placebo of hope is rampant in anything that is tried – be it nutraceutical or clinical drug – science demands proof of efficacy.

145 years in, and there is still nothing efficacious in the world of ALS treatment. Ritulek fits into the nothing category. Is it any wonder that people take their lives into their own hands and search out other answers after having been given a death sentence? People respond to this challenge in their own unique ways.

One way is to participate in clinical trials. Another way is to try and find a combination of nutraceuticals that could be helpful. The very best summary I have ever read regarding supplement protocols and ALS, can be found on the ALSTDI forum. The post was written by a man named Dave J.  I have not asked his permission to use it on this blog, however, it is freely accessible on the above mentioned forum, but you must log-in to view it.

For those who have wandered onto this blog and who are not family members, I repeat myself saying this:

Disclaimer: The following information contains my own personal and medical views regarding what I would hypothetically do for myself or a loved one if faced with this life threatening disease. In no way is it a recommendation for anyone with ALS to follow. It is always best to seek the advice of your medical care practitioner when undertaking any type of therapy; and preferably, a medical care practitioner who is open-minded, open-hearted and compassionate.

For my family:

Dave J's Proletariat Protocol for ALS

Some of what Dave J. writes is not unlike what I have been suggesting for the past few years. There are some things that I would alter in my recommendations from last year, and some differences I would recommend than what he has written in the “Proletariat Protocol”. Here's what I would do:

  • a ketogenic diet (healthy high fat);  a high quality protein diet;  no junk, no artificial crap, no refined sugar
  • a gluten-free diet (or grain-free diet, but only if body weight can be maintained or increased)
  • a low beta-sitosterol diet
  • lots of coconut oil, fresh vegetables and fresh berries
  • bio-identical hormones specific for your needs as determined by a 24-hour urine test
  • magnesium glycinate, taurine, B-complex (with 5-MTHF, P5P and methylcobalamin), ALCAR, DHA, lipoic acid and resveratrol
  • don't load up on antioxidants as this might squelch your body's adaptive responses; forget the Vitamin E and CoQ10
  • only consider TMG if your homocysteine level is elevated
  • IV glutathione and IV methylcobalamin
  • light weights and gentle exercise (somatics, qi gong, tai chi, yoga or stretching)
  • trust your own body to help you determine what is right for you: one size does not fit all

Added to my list this year:

  • zinc picolinate (mostly for the prevention of respiratory illnesses)
  • Berberine HCl
  • Boswellia serrata

Zinc is an interesting mineral that is presently being used for experimentation by patients who are conducting their own DIY trial.  Their underlying notion is a problem with copper toxicity:

http://alsanesthetics.org/copperstudy/pilotreport/freecopperstudy_report.html

http://alsanesthetics.org/research/2013-12-31-15-16-18/5-real-time-status-of-the-free-copper-trial

I sometimes wonder if any of the benefits experienced from this DIY experiment might be due to the fact that zinc inhibits copper absorption, helping some people with hypouricemia.  High serum uric acid levels are found in pALS men who have slower rates of progression.

Magnolia is a botanical I've used many times for patients with insomnia. I have not found it to be efficacious at all as a stand alone herb. As for its beneficial effects with swallowing difficulties, I have no clue. You would have to give it a whirl to assess its efficacy.

Do not use 5-HT unless you are also taking L-cysteine (or NAC), L-tyrosine and maca pruriens. (See Dr. Marty Hinz's work at NeuroResearch).  Better yet, don't bother taking it unless you need emotional support via nutraceutical therapy.  ALS is not a post-synaptic disease.

Curcumin is an interesting botanical medicine. It is highly recommended for all types of conditions because of its anti-inflammatory properties, and that is why pALS are taking it. There is much research on this herb for many other conditions, and yet I have never been impressed with its use as an anti-inflammatory agent in clinical practice. Even the Integrative Medicine website called Natural Standard gives this herb a rating of “C” regarding clinical efficacy for a long list of conditions; “C” meaning “unclear scientific evidence”.

On the other hand, an herb like Boswellia, which also crosses the blood brain barrier and decreases neuro-inflammation, is a much, much better anti-inflammatory in botanical medicine. I've been very impressed with this herb in clinical practice for other conditions, and the Natural Standard gives it an “A” (strong, positive scientific evidence), at least for osteoarthritis, and a “B” (positive scientific evidence) for asthma and brain tumours (with radiotherapy).

I would use Boswellia before I used Curcumin any day of the week. However, the former is a bit hard on the gut for some people, depending on how high in dosage you go.

Last year I talked about Echinacea. I would nix it this year and replace it with Berberis. Berberine crosses the BBB, it is known to decrease microglial inflammation, and it is an excellent botanical for the prevention of many types of microbial infections, especially in people whose respiratory system is compromised. For a wide variety of other conditions in clinical practice, Berberis is one of the best botanical medicines on the planet, IMHO.

I can't leave the topic of Curcumin without discussing a molecule called J147. This molecule is a synthetic extraction of this herb and 100 times more potent. The most amazing thing, is that an incredible man named Eric Valor (whom I have written about before), while being completely paralyzed on a ventilator and with only eye movement, has been able to create a company that will test this molecule on animals prior to using it on ALS patients. Simply, mind blowing!

PLEASE DONATE TO THIS WORTHY CAUSE HERE:

J147:  Therapeutic for ALS

Dave J. has listed the do's and don'ts of this illness pretty thoroughly in his "Proleteriat Protocol".

I would also add, not to bother undergoing any type of chelation therapy. 1) There is zero evidence it is helpful. 2) Many important minerals that are necessary for neuronal and muscular functioning are removed during the process. 3) There is no clear evidence that heavy metal toxicity is associated with ALS. 4) There is inadequate information as to whether a chelating agent crosses the BBB, or whether toxic metals are actually removed from neural tissue or redeposited from other tissues back into the nervous system during the chelating process.

Regarding the prevention of ALS, we do not know if this disease can be prevented, and therefore there are no known strategies. If I were to take a guess however, I would recommend that you, my family, do these few things:

  • reread my blog on “Grain Brain” and Dr. Perlmutter
  • avoid environmental toxins to the best of your ability
  • if you partake in an excessive amount of exercise (a marathon race, a 10 hour steep mountain hike, etc.), temporarily take some type of glutathione support immediately after the exertion; this could take the form of NAC, milk thistle, selenium, lipoic acid and resveratrol. With extreme exertion, I personally give myself a glutathione intravenous injection.

Over the past 2 years, on a forum called ALSTDI, I've read thousands upon thousands of posts written by the most incredible people I have ever had the honour and pleasure of reading. They are the heroes of this world. These are people who face insurmountable challenges everyday and come together on a forum to try and find solutions for a disease that has not even had one single solution for the last 145 years now;  solutions that have escaped the most brilliant and talented scientists in the world.

This will be my last blog on ALS. If I blog about this topic again, it will be because there has been some incredible break-through treatment that has been discovered.

I hope I will be blogging soon, however, I don't know . . . .

Hope and optimism are on the distant horizon, or right in our laps. It depends upon our perspective.

EDITED TO ADD (Nov. 28/15)

I’ve been following Dr. Marty Hinz’ work for the past 15 years, and have used it successfully for other conditions.

I’ve always thought that ALS was related in part, to some type of neurotoxic insult, and that is why I thought IV GSH was a good idea. GSH does not cross the BBB, nor does NAC. For chronic conditions associated with thiol collapse, L-cysteine is both inexpensive and crosses the BBB, which makes it a better choice for dealing with neurotoxic problems.

However, L-cysteine also transports methyl mercury across the BBB and thus selenium is used to counteract this problem.

5-HT and L-tyrosine are used to prevent neurotransmitter imbalances that can occur with using only sulphur amino acids, since eventually, L-cysteine can deplete dopamine and serotonin.

Long ago, I asked Dr. Hinz if any of his findings in his research would help those with ALS. He said no, because ALS is not a post-synaptic disease. But recently, I saw MND on his list of diseases that could (theoretically) be helped because they were diseases presumably associated with thiol collapse.

http://new.neurosciencemyths.com/n-acetylcysteine

I’m not naive enough to think this could be curative for ALS, but I do wonder if it could help just a titch? and maybe a lot in some people?

Just passing this on before I shut this blog down.

I'm a Born-Again Dog Lover

DSCN0626Yesterday I knew without a doubt, that I had graduated into the realm of being a born-again dog lover. It wasn't always that way.  I was pretty much neutral about dogs most of my life, even though I've had one dog or another for the past 35 years.  The only reason I have had various dogs over these years was because my husband and children were the dog lovers in the family.

For a non dog-lover back then, I definitely got the short end of the stick.  Can you guess who did all of the crappy jobs?  Like cleaning dog poo accidents from the floor?  Like extracting huge and gross-looking blood-filled dog ticks from the butt with tweezers?  Like giving mouth to mouth resuscitation to newly born pups?  Like administering gastric tube feedings to the only surviving pup in a litter?

Yup.  You guessed it.  The Queen of Dog Neutrality.

So when our 15 year old dog died in May of 2012, not all of the pleading and begging in the world to bring another dog into our home, coming from my husband or child would change my mind - or so I thought.  I was firm.  NO MORE DOGS.  Never.  I did my part.  I compromised more than I thought I ever could, over 3 decades.  I was done.  Definitely.  NO MORE DOGS.

Okay, so I caved.  Overwhelming pressure coming from my husband, child and a dear friend (who is a stellar dog owner) were too much, and cave I did.

This time, I was determined to have a different doggy experience than I ever had before.

Six weeks after she was born, which was September 1st, 2013, we brought home a puppy from Parkridge Goldendoodles.  We named her Maple.528517_464802023543011_939183860_n-1

If someone told me 5 years ago, that I would be doing the following things with, and for a dog, I'd have said that he or she was plum crazy:

  • give her a shampoo bath every 2 weeks
  • blow dry her fur after her bath during the winter months
  • make and cook her food from scratch
  • consider myself to be her 'mom' (yes, I know, I can't even believe it myself)
  • pluck the hair out of her ears every week
  • discharge her anal glands periodically (no, you definitely don't want me to post a You Tube video of this procedure)
  • talk baby-talk to her (yeah, I know, - completely ridiculous!)
  • really like and care about every dog I see now (except for mean, aggressive dogs)
  • rearrange my work-schedule so that I can participate in a hiking group that allows dogs to also participate
  • take her everywhere we go:  to our clinic, to the airport, to stores that allow dogs, on camping trips, . . . simply, everywhere

Screen shot 2014-02-20 at 2.33.16 PM

For 1 -1/2 years now, I have been behaving like this.  I just chalked it up to weird behaviour due to menopausal transition.  Nothing more than that.

However, yesterday, I knew that I had become a full-fledged born-again Dog Lover.

Our neighbour called me, and in a very polite and nondirect way, complained about Maple's barking.

When I got off of the phone, I thought, "suck it up buttercup".  Dogs bark.  That's what they do;  just like birds caw, and children scream while having fun.  Dogs indeed do bark.

But what clued me in to my new born-again status, was how defensive I felt about my baby.  I had never felt like this about any animal before.  This neighbour was criticizing my well-behaved, fun-loving, intelligent, affectionate, caring, enthusiastic, gentle and perfect creature, and I was not about to take off my rose-coloured glasses.

I knew I had finally crossed the line of no return, and was now reborn into a special group of people who are authentic dog lovers.  I now welcome myself into this club of special people, and in doing so, I end this blog by expanding upon this born-again metaphor with a quote from Robert Louis Stevenson:

“You think those dogs will not be in heaven! I tell you they will be there long before any of us.” 

What's With People in Smithers Avoiding Wheat and Gluten?

unknown-1People in Smithers are very, very smart. Okay, that's the short answer to the question.

Actually it isn't just people who live in Smithers who are avoiding wheat and/or gluten and/or grain en masse.  It's pretty much global at this point.

The impetus of  this blog came about after I attended a medical conference this past weekend in Smithers.  The lectures were given by an assortment of professionals:  specialists, GPs and a pharmacist.

The first lecture was given by a general surgeon who travels to rural Smithers to administer necessary care.  He made a query and comment regarding the dumbfounding number of people in this town who have removed wheat from their diet.  "What's with that?", he rhetorically asked.  His tone was mildly derogatory, and his comments were followed by sarcastic snickers from the GPs in the audience.  These were the kind of snickers that clearly spelled out the phrase, "This is nonsense!"  (short of a definitively diagnosed celiac disease or an IgE-mediated wheat or gluten allergy).

I felt my face go red.  I don't easily blush from embarrassment, but I swear I was crimson at that point.  I knew that I had been a major contributor to this wheat-free, gluten-free and grain-free phenomenon in this town for the past 19 years.

The snickering was not unlike the, "This-is-nonsense!-snickering" sounds that I hear when I attend a naturopathic conference, and a speaker is making jokes about the reductionistic and suppressive approach of allopathic (conventional) medicine.

In trying to understand the flavour of this type of snickering, I imagined that I too would be guilty of engaging in "This-is-nonsense!-snickering" behaviour if I were to attend a conference about inflammatory bowel disease and sit through a lecture discussing the plausible efficacy of fecal transplants.

The truth is, that none of these topics are nonsense;  shoving someone else's poop up the butt could be helpful for some;  suppressing symptoms and reducing a patient to a body part in an acute crisis, is lifesaving;  and eliminating wheat or gluten or grain in many people without frank disease is unequivocally and beneficially life altering for many.

I now equate snickering to, "I haven't a clue".

And wouldn't you know it?  Coincidentally, the topic on the following day was a lecture about celiac disease and non-celiac gluten sensitivity given by a gastroenterologist.

I will make a confession here before I go on.

Until this past weekend, I used to have a prejudice against gastroenterologists.  Previously, I had this stereotypical image of a cranky, old, bloated (both in the head and gut) specialist, with a waiting room full of people who would be better served by going to see a naturopathic doctor.  This exaggerated stereotypical specialist would tell every patient he saw, "your disease has nothing to do with what you're eating".  Meanwhile, any patient could have changed her diet dramatically and put her own disease into complete remission, yet this bloated doc would still be condescendingly using verbal diarrhea to basically repeat his same one-liner to his patient, "your disease has nothing to do with what you're eating".

This past weekend, my long-held stereotype of gastroenterologists was pleasantly and completely shattered.

First off, the speaker was stunningly beautiful, slim and young.  She was well-spoken, and her manner was very sophisticated, absent any type of arrogance.  She talked about celiac disease  and the risks of not obtaining a definitive diagnosis for this condition.  She talked about latent and silent celiac  patients who have not yet displayed abnormal biomarkers.  She talked about the many patients who did not have celiac disease but are gluten sensitive instead and are known as non-celiac gluten sensitive (NCGS).  And she also explained that the reaction to gluten in NCGS patients might not be because of an intolerance to gluten, but rather, an intolerance to short chain carbohydrates as seen in a high FODMAP diet.

When she was asked about people where celiac disease was ruled out, yet experienced dramatic improvements in their health with the removal of wheat or gluten or grain, her response to these patients was, "Great.  Keep going".

My view of gut specialists did a 180 degree turn right then and there.  She was a specialist who knew her stuff and beyond.

The take home messages of her lecture for me, were these following points:

1)  a small bowel biopsy should always follow an elevated tissue transglutaminase IgA test to obtain a definitive diagnosis for celiac disease

2)  if celiac disease is strongly suspected, a serum IgA should also be done along with a tissue transglutaminase test, since low serum levels of IgA can render the latter test negative

3)  a patient must be eating gluten for 6 - 8 weeks prior to blood work (non-genetic testing), since avoidance of this food can render the test negative

4)  gluten does not need to be eliminated from the diet for genetic testing, and a positive result does not necessarily definitively conclude a diagnosis of celiac disease, yet a negative result can rule it out

With the incidence of celiac disease being 1 in 100, it is crucial to determine which people actually have this disease.  The importance being, that many complications can develop if these patients do not adhere to a very strict gluten-free diet;  bowel cancer and lymphoma being the most dangerous sequelae.

Certainly, all people with gastrointestinal symptoms who are experiencing weight loss, anemia and altered bowel function should at the very least, always be tested for celiac disease.

It's everyone else in the gray zone where the challenge remains.  This gray zone consists of silent/latent celiac patients who have the genetic predisposition to go on to develop the full-blown disease and whose biomarkers are negative, all the way to people with NCGS.

There are no easy answers.  Many people take themselves off of gluten and wheat because of the popularity of books like the Wheat Belly and Grain Brain, and notice incredible changes in their health, well-being and quality of life.

I have recommended the elimination of wheat or gluten or grain to many patients who have not presented with a "clear celiac picture", but because they have displayed elevated IgE or IgG4 antibodies to these substances.  IgA antibodies to gliadin is another type of test that can help determine if one has NCSG.  Electrodermal testing can also aid in trying to determine those with NCSG, and breath testing for SIBO may provide some clues as well.

This all begets the question, should everyone be screened for celiac disease?  My answers is both yes and no.  Screening everyone for this disease would place an unreasonably high financial burden on our Canadian health care system, and the allocation of these funds could be best served elsewhere, IMHO.  So no, for that reason.

However, I do believe that everyone who chooses to eliminate gluten or grains from their diet without a definitive diagnosis of celiac disease should take on the responsibility of financially paying for their own testing.  A lab in Canada called Rocky Mountain Analytical will do this for those who aren't squeamish about poking their own fingers.  For the adventurous who choose to do this on their own, you MUST be eating gluten for 6 - 8 weeks prior to testing.  If your test shows positive for tissue transglutaminase A, do not remove gluten from your diet, but head to your medical doctor for further testing and a definitive diagnosis.

Personally, I'm waiting for Cyrex labs to come to Canada (which rumour has it will be coming in a few months), for the most comprehensive gluten test available, and is recommended by Dr. David Perlmutter MD.

Some people wonder, if removing gluten and grains from their diet makes them feel so damn good, why bother testing in the first place, and especially with something as invasive as a small bowel biopsy.

The answer lies in the compliance and strictness of gluten removal.  Not being strict with the diet if you are celiac, over the long haul, can be fatal.  Not being strict with the diet if you are NCGS, is a big unknown regarding future complications and the development of lethal conditions.  However, Dr. Perlmutter in Grain Brain, uses scientific and epidemiological studies to counter this last statement, and believes that the damaging effects of gluten and grains are much more known than we are led to believe for the non-celiac population.

I will share with you, 3 extreme examples of celiac disease to illustrate my point.

I saw a woman in her mid-50s with typical general complaints:  fatigue, mild dyspepsia and mild depression.  All of her blood work was normal, except for a low ferritin that was still within normal range.  She did not present with frank celiac symptoms and understandably, her MD did not do a tissue transglutaminase test on her at that time.  I also did not consider doing one.  After I saw her, I did an IgE and IgG4 food allergy/intolerance test of 90 foods and found her to be positive to many substances, one being gluten.  Her health dramatically improved with the elimination of the foods she tested positive for.  She was compliant with this dietary regime for less than a year.  Many years had past and she resumed her pre-food-testing diet.  Her symptoms returned and she told her MD that she felt better off of gluten and dairy products.  Based on that information, this MD proceeded to do a tissue transglutaminase test, which was found to be positive.  This abnormal finding was followed up by a conclusive positive small bowel biopsy.

This is a case where an earlier definitive diagnosis may have assisted in advising this patient of a strict no-cheating policy when it came to gluten, thus helping her avoid a few extra years of unnecessary discomfort and illness.  However, as seen in the next case, compliance is an issue even in those who have been definitively diagnosed with celiac.

A woman in her 70s was definitively diagnosed with celiac disease in her youth, but for whatever reason, chose not to be compliant with a gluten-free diet.  She died of lymphoma, very likely related to poor dietary regulation of her celiac disease.

So what is more important?  A definitive diagnosis?  Or compliance?  Both are equally important.

Then there is the extreme case that neurologist, Dr. Perlmutter describes in his book, Grain Brain.  A patient was misdiagnosed with ALS and ended up finding out that he was really only a celiac patient.  Can you imagine going from being told that you have one of the most horrible diseases on the planet, and that you'll die in 2 - 5 years where you won't be able to move anything but your eyes, and you won't be able to breathe without a machine - going from THAT, to just having to remove gluten from your diet?!?!?  OMG.  If that was me, I'd be kissing the ground and thanking any type of deity I believed in (God, Allah, Buddha, Krishna, Darwin, Science - any God), and thanking this deity that the only thing I had to learn was how to make delicious gluten-free meals and which restaurants to avoid, instead of having to decide in a few years whether or not I wanted a breathing machine and 24-hour nursing care to keep me alive.

NCSG people also have experienced neurological deficits as seen in this study.  In practice, I have also seen many types of neurological symptoms, even those that looked like multiple sclerosis, disappear with the elimination of gluten in NCSG patients.

My family and I have been gluten-free for 20 years now as I have previously mentioned in this blog.  After listening to the gastroenterologist give her talk, I asked myself if I was best serving all of the patients I see, as well as my own family.

With my husband, he is the easy one.  There would be no reason on earth to do a celiac test on him because he is more strict about being gluten-free than any celiac patient I have ever seen, and he will continue to do this for the rest of his life because he feels much better for having done so.

With myself, I have little reason to believe that I have celiac disease and I eat gluten very rarely in the form of filo pastry once per year.  However, I enjoy how I feel when I avoid both gluten and grains from my diet.  With my older daughter, her experience is similar to my own.  I will likely do genetic testing on the both of us, and only if the results are positive, will I pursue further testing for celiac disease.

My younger daughter is a different story.  She was extremely ill for the first 2 years of her life until I did an IgE and IgG4 antibody food test on her and removed the offending foods, one being gluten.  She defied her pediatrician's predictions of growing up to be a child with life-long respiratory problems, and continues to experience remarkable health to this day.

When she was 6 years old, her new pediatrician in Smithers did extremely comprehensive testing on her, and one of the tests he did was a tissue transglutaminase for celiac disease.  The test was negative, but she had been gluten-free for 4 years prior to the test.  Therefore, it was not a valid test for her at that time.

Now, as a young adult, she still is pretty much gluten-free, but has gluten foods about once per week.  She is the exact type of person I would want to definitively know whether she has celiac disease or not.  Why?  Because if she is not strict and she has celiac disease, she could be open to a whole host of potential problems like osteoporosis, cancer, neuropathy, depression, anxiety, reproductive problems and birth defects.

When Cyrex Labs comes to Canada, I will recommend that my youngest eat gluten consistently for 6 - 8 weeks, and then do these tests.  Yes, it will likely be a very crappy 6 - 8 weeks for her.  Hopefully her health won't plummet too terribly.  After all, it's been 18 years, and we have never challenged her system with gluten for more than a few days at a time here and there, from the age of 2 on.

To wrap up this entire discussion, there is no one size that fits all in diagnosis, diet or disease testing.

There are many people who remain healthy and vibrant while eating wheat, gluten and grains and do not have NCGS.

However, many other people in Smithers and around the globe have figured out that one size does not fit all, and have used their own personal laboratories; - their own bodies - to obtain valuable, observatory data from.  This is what I call smart medicine.  The caveat here, is please do this wisely.  You do not want to end up removing gluten from your diet in a half-ass non-strict way if you are sitting with a potentially life-threatening disease.

Daphne Moser 1946 - 2014

Unknown-1This past Friday I attended the funeral of an exceptional woman. Daphne Moser was the Anglican minister of the Anglican churches in the Bulkley valley.

I first met Daphne at the St. John's Anglican church in Quick.  Once a year, our family would attend Christmas Eve services at this quaint little church powered by candlelight and woodstove.  The presence she exuded was always warm and gentle.

It wasn't until I needed her assistance that I understood the loving depth of her character.

It was the spring of 2010 when I called to make an appointment to talk with her at the St. James Anglican church in Smithers.  I had a pressing matter I needed to discuss.

Our youngest daughter had been physically and verbally bullied in the public school system for 3 years.  My husband and I knew we had to make some drastic changes, and we reviewed our options:  homeschooling, the alternative school, or the Christian school.  While the first two choices could have been fine, we did not believe they would offer our child the necessary social development she specifically needed.

In choosing the Christian school, we needed to have a minister fill out an admission requirement form before our daughter would be able to be accepted into the school.

I sat down in Daphne's office.  She asked what she could do for me.  I told her that I wanted the best for my daughter, but I didn't want to be a hypocrite.  I told her that while I loved the teachings of Jesus, I did not share all of her Christian theological beliefs.  I proceeded to share with her my beliefs.  She listened and listened and listened and listened.

She then said to me, "We all come to God in different ways".

On the part of the admission form where it asks, in what way did our family contribute to the church, Daphne was enormously generous to write that I had played the pump organ at St. John's.  I had only played it a handful of times during a few services.

Daphne heard our need.  She was in a very unique position of being both minister and previous school teacher.  She opened her church and her heart to our family in our time of need.

Before I left my meeting with her, in the most gracious, kind and wise way, she said this to me, "We don't have to share all of our beliefs with everyone".

Our daughter spent 3 wonderful years at the Bulkley Valley Christian School;  was respected, nurtured and loved.  She experienced the beauty of Christ's most loving teachings.

When our daughter was about to graduate, Daphne announced this, to the entire congregation at Camp Caledonia.  It was one of the best church services I had ever attended; outside in the sunlight under a sheltered building, with a guitar strumming and beautiful singing harmonies entwined with the surrounding nature.

Daphne made time to attend our daughter's graduation, and as a gift, gave her a wooden cross she obtained during her pilgrimage in Spain, walking the Camino de Santiago.

We will be forever grateful to Daphne for her love and for seeing our needs.

On the back of the pamphlet of the memorial service celebrating Daphne's life, was a joyous picture of her, with the following words written below:

And now faith, hope and love abide, these three;  and the greatest of these is love.  1st Corinthians 13:13

Daphne lived the theology of love.

Thank you so much Daphne.

The Great Cholesterol Myth

great_cholesterol_myth_graphic_1815631625_588968144I attended a naturopathic medical conference this past fall, and the best lecture hands down was one given by Dr. Stephen Sinatra MD. The lecture was entitled: “Metabolic Cardiology: A New Nutrient Therapy for Cardiovascular Disease”. This lecture was inspiring and full of knowledge that I considered to be “truth” when it came to illness and disease. Much of the lecture contained information that coincided with the way I have practised medicine for the last few decades now. When information rings true, it just rings true. Scientific studies are important when trying to determine best plan of care, and so is plain old common sense. I just finished reading the book that Dr. Sinatra co-wrote with Dr. Jonny Bowden, PhD, entitled, “The Great Cholesterol Myth”. Dr. Sinatra also has a valuable and informative website called Heart MD Institute.

When a highly respected neurologist (Dr. Perlmutter of Grain Brain), and a highly respected cardiologist (Dr. Sinatra), are saying basically the same things regarding nutrition, the prevention of disease, and the role of cholesterol as it relates to illness, this information cannot be ignored. Both books provide reams of solid scientific studies that support each of their opinions and recommendations;  one from a neurological point of view, and one from a cardiovascular point of view.

From a metaphorical perspective, when the mind is open (brain/neurology) and the heart is open (cardiology), it is much easier to ascertain what is truth. As well, when scientific study after scientific study, shows similar findings in very different disciplines, truth is within reach. And from a physiological point of view, the brain and the heart are in constant communication like a “heart-brain hotline” as is described in “The Greatest Cholesterol Myth".  When a heart-mind connection is in sync, there is truth in them thar' hills.

If you or someone you love has cardiovascular disease, or you have a family history of heart problems, this is probably the most comprehensive and entertaining book you will ever read on the subject. I laughed out loud so many times while reading this book because the authors have a great sense of humour. They explain complex concepts in very simplistic language and in analogies that are really quite clever. I will never see a free radical the same way again, but only as a hormone-fuelled college sophopmore trying to hit on a couple who are in a stable relationship. The book is loaded with awesome analogies.

Here are some highlights from the book:

  • elevated cholesterol is a non-existent disease and the lipid hypothesis is a crock
  • regarding cholesterol, small dense LDL (type B) particles are the problem and saturated fat helps combat these dangerous molecules
  • Lp(a) (lipoprotein a) is one of the most devastating risk factors for heart disease and it is difficult to treat (i.e. no drug therapies address this risk factor)
  • sugar is the problem not fat;  in fact sugar, stress, inflammation and oxidation are the problems
  • the cholesterol measurements you get at your MD's office are outdated and of limited value
  • instead of getting the regular cholesterol measurements done, the following tests are far more valuable in assessing your cardiac risk profile:  LDL particle sizes, hs-CRP, fibrinogen, serum ferritin (iron), Lp(a), and homocysteine.
  • high levels of HDL ("good" cholesterol) mean nothing if you don't know if it's the good-"good" kind or the bad-"good" kind
  • high levels of insulin can increase your blood pressure and cholesterol, and insulin is related to sugar intake
  • many studies show that those with low cholesterol die sooner and experience many other problems

As well, an entire chapter is devoted to discussing and managing stress, since the stress response can save your life or kill you.  Stress and elevated cholesterol go hand in hand.  It's worth getting the book for this chapter on stress alone.

After reading the chapter on stress, there were 3 take home messages for me:  1)  meditation  2)  community, and  3)  creation of disease from the perfect storm.

Meditation.  For me, meditation has always been freakin' boring.  I've tried all kinds:  transcendental meditation, guided meditation, silent meditation, etc.  They are way too boring for me because my mind is always so active.  My friend Monika is in the process of completing a 10 day Vipassana meditation retreat, where she has been meditating all day long for 10 days in a row.  Can you imagine?!  In my mind, that would take incredible gumption and fortitude to do something like that.  Being thus inspired by my friend, and being thus reminded of Herbert Benson MD's work with "The Relaxation Response" (as discussed in chapter 8, "Stress:  The Silent Killer"), I have committed to meditate 20 - 30 minutes twice daily from here on out.  My New's Years resolution has begun early, because I know that the benefits that await me are enormous if I can persist with a regular disciplined meditative practice.

Community.  Again, I was reminded by the wonderful study done long ago in Roseto, Pennsylvania, where heart disease was shown to be much reduced in this town compared to the national statistics.  Even though the men in Roseto worked in underground mines, smoked, and ate foods fried in lard, they had strong family ties and were nourished by community.  Connection and community was the reason for the low incidence of heart disease in this town.  The sense of community, belonging, and support, cannot be underestimated when it comes to the promotion of great health.  I feel very blessed to be part of many communities;  my nuclear family, my extended family including friends and relatives (that put up with all of my boring blogs), my BV backpacking group, my naturopathic medical community, and the Bulkley Valley community where I live.  I am grateful for these connections.

Creation of disease from the perfect storm.  Sometimes toxic influences, - be they from food, or from water, or from air, - can be tolerated and adapted to.  Add stress into the mix, and illness takes on a whole new dimension and level of creation.  For more info, read about the frog experiment in chapter 8, or in this article from where the experiment derives.  (It's much more fun to read the chapter!)

The authors of the book also have a chapter on nutrient supplements for heart disease prevention and treatment.  This chapter is a very specific and excellent resource to use, should you ever need this valuable information.

The chapter on nutrition does not lay out a blow-by-blow diet plan as found in "Grain Brain", but specifically states the Do's and Dont's (or the "Eat it" and "Dump it") of managing healthy eating.  The ideas are very similar in both books:

  • go wild on the veggies, especially green leafies and cruciferous vegetables
  • berries, and other fruits in moderation
  • nix the sugar, processed carbs, processed junk, processed meats, trans fats and omega-6 oils
  • nix the pastas, breads, cereals, cookies, cakes, doughnuts, pastries, white rice and crackers
  • go heavy on the olive oil
  • wild Pacific salmon, grass-fed beef, nuts, dark chocolate, tumeric and red wine are good to go

The differences in both books regarding nutrition are small.  While Sinatra and Bowden acknowledge that gluten sensitivity may be problematic for some people, Perlmutter takes fire and aim at gluten.  Sinatra and Bowden like beans, but Perlmutter, less so, because of the carb load.  Perlmutter's self assessment questionnaire lists not drinking wine as a risk factor for neurological problems, and while Bowden and Sinatra acknowledge the benefits of polyphenols found in red wine for cardiovascular health, they also state that if one does not drink, now is not the time to start!  Thank you Dr.'s Bowden and Sinatra.

So instead of resorting to getting my neurological and cardiovascular health-fix from booze, I've decided to get my concentrated red wine polyphenols in capsule form.  This capsule also contains 100 mg of an antioxidant that both the 'Grain Brain' and 'The Great Cholesterol Myth' believe to be fabulous for the brain and the heart respectively.  That anti-oxidant is called trans-resveratrol.

Regarding fats, all three authors like saturated fat, monounsaturated fat, and omega-3 fatty acids, and don't care much for omega-6 pro-inflammatory fats.  Perlmutter drives the message home with much more gusto and goes out on a limb to recommend a high healthy fat diet.  And obviously, being a neurologist, he would.  The brain loves fat way more than the heart does.  However, "The Great Cholesterol Myth" has the following chart on page 75, which, along with avoiding sugar and junk completely, is the most important nutrition suggestion in the whole book (IMHO):

Screen shot 2013-12-11 at 8.34.05 AM

(I hope I'm not infringing on any copyright issues since I copied it from Amazon.com).

Anyway, there you have it.  If I have changed one thing in my diet, it is eating much, much more of these healthy fats on a daily basis.  (That is, eating more saturated fats, even more monounsaturated fats and more omega-3 fatty acids, and not eating any omega-6s).

Regarding eggs, dairy and poultry, Sinatra and Bowden don't say much.  Perlmutter highly and regularly recommends eggs, as well as goat cheese and some hard white cheeses.

Like I've said many times on this website before, one size does not fit all.  After common sense basics and perhaps some food intolerance/sensitivity testing, personal experimentation regarding what works best for each person trumps just about everything.

The last topic I'll cover is statins.  (These are minimally useful drugs, unlike other useless cholesterol-lowering drugs like fibrates).   I'll try not to belabour this topic, suffice it to say the following:

  • if you are on a statin drug or your doctor wants to put you on a statin, read this book first
  • statins are way over-rated and can cause lots of problems;  the reason they work for a select few is not because of their cholesterol-lowering effect, but because of their anti-inflammatory properties
  • statins prescribed for children, the elderly, and for most women, is bad medicine
  • statins reduce the life-giving molecule called cholesterol, that is needed for so many crucial functions in the body
  • if you must take a statin, make sure you're also taking Coenzyme Q10 100 mg twice daily, and Vitamin D as measured by blood tests
  • Canada is much more on the ball than is the US when it comes to not prescribing statins for the primary prevention of heart disease (i.e. a person who has high cholesterol but has never had a heart problem before)

Here's what Dr. Sinatra says on his website regarding those people who could benefit (though not necessarily will benefit) from statin drugs:

"I stand firm by my opinion that statins should be prescribed only to men and women with advanced cardiovascular disease, and who do not have diabetes, and individuals with genetically-based high LDL cholesterol that can hasten coronary artery disease. For these people, the benefits outweigh the risks, but it is mostly for the therapeutic anti-inflammatory value of statins and not any cholesterol-lowering effect."

That is exactly what I believe also.

The new guidelines for the treatment of cholesterol to reduce heart disease as put forth by the American College of Cardiology will have more physicians prescribing more statins to more people.  Sheesh!!  What a freakin' disaster-waiting-to-happen that will be - for both brain and heart, - not to mention the immune system, joints, muscles, sexual function, etc.

Canada has it bang on though, thank God.  In his article entitled "It's time to question the new guidelines on cholesterol drugs", health journalist Andre Picard reminds us that Canada has not adopted these new guidelines.  Yay Canada!!  In this new article in BMJ, "Should people at low risk of cardiovascular disease take a statin?", it is plainly obvious that the benefits do not outweigh the risks.

In reading both the "Grain Brain" and "The Great Cholesterol Myth", I have changed my thinking on a few things.  I'm not going to brag about my 'perfect' cholesterol levels anymore, that range anywhere between 3.6 - 4.4 mmol/ (140 - 170 mg/dl).  No.  I am now actually aiming for much higher cholesterol levels, and even though dietary cholesterol does not create a huge impact on overall levels, it can have a minimal influence.  After reading both books, I have dramatically increased the volume of my healthy fat consumption using the foods in the chart above.

The last change I'm going to make, is to stop asking patients to get their cholesterol levels checked by their primary care physicians.  I will start doing tests myself, measuring values that are of significance to cardiovascular risk prevention, like LDL small density particles, oxidized LDL, Lp(a), Apolipoproteins A & B, homocysteine, hs-CRP, plasma Coenzyme Q10 and red blood cell magnesium levels.  I had done this in the past very sporadically and infrequently, but now I know, that it's the only reasonable way to go.  Here's a sample report:

Screen shot 2013-12-15 at 10.53.50 AM

I will start this coming Monday, beginning with myself and Bill.

Cholesterol is really a beautiful molecule and the demonizing stories created around it are akin to the evil villain myths of yesteryear.

Grain Brain

slide2OMG.

FINALLY.  FINALLY.  FINALLY.

I HAVE FINALLY BEEN VINDICATED, AND INFORMATION THAT IS PLAIN OLD COMMON SENSE HAS GONE MAINSTREAM.  FINALLY.

Sorry for yelling.  I'm just excited.

Neurologist Dr. David Perlmutter M.D., wrote a book that was just released this fall:  "GRAIN BRAIN:  The Surprising Truth About Wheat, Carbs, and Sugar - Your Brain's Silent Killers".

If you have Type 2 diabetes, READ THIS BOOK.

If you have a blood-related family member with a neurodegenerative disease, especially Alzheimer's disease, READ THIS BOOK.

If you have depression, anxiety, ADHD, chronic headaches, insomnia, epilepsy, movement disorders, digestive symptoms, arthritis, Tourette's syndrome or schizophrenia, READ THIS BOOK.

If your cognitive function and memory are declining as you age, READ THIS BOOK.

If you are overweight, READ THIS BOOK.

If you have no problems at all, and just want to have a bit more insurance that your little grey cells will fire the way you would like them to as you age into your 50s, 60s, 70s, 80s, and 90s, - then READ THIS BOOK.

I believe everyone should read this book, because it could possibly mean the difference between living a life of misery, or living a life without it.

First of all, let's get one thing straight.  This is not a cure all book for every disease under the sun, nor does this doctor even come close to suggesting this.  In fact, this is not a book that will help everyone, whether or not you have an illness, brain-related or otherwise.  After all, ONE SIZE DOES NOT FIT ALL.  Many people actually do quite well with moderate amounts of organic unprocessed whole grains.

However, this is a beyond hopeful book, that challenges the notion that brain disorders are our genetic destiny and that there is nothing we can do to prevent or ameliorate them.

Why should we even listen to this guy?

We should listen because we deserve to be optimally healthy.

We should listen because Dr. Perlmutter is a rarity of rarities:  he is a board certified neurologist plus a fellow of the American College of Nutrition.  Neurology (high-minded science-based medicine) and Integrative/Holistic medicine, typically do not mix;  worse than oil and water in fact. However, this MD has shredded that stereotype and ripped the box of conventional thinking wide open and has made a much bigger box.  If physicians truly want to help all of their patients (not just those that respond positively to pharma and surgery), they will, at the very least, educate themselves with the material Dr. Perlmutter has written in his book: the scientific data that supports his position, the anecdotes of the successes he writes about, and a general plan for patients to follow with the support of their physician.

Why wait until 20 - 30 years from now for randomized blinded clinic control trials (that may never happen) to affirm what this doctor is saying is true?  The damage for many will be irreparable by then.  There is enough science at the present time to push the red warning light and motivate us to change, NOW.

For example, how scary is the following information?  Babies born to gluten-sensitive women have an increased chance of developing schizophrenia and other psychiatric disorders.  He goes on and on and on about the potential dangers of sugar, gluten, grain and a high-carb/low-fat diet.

What are some of the highlights of this book?  The same things I've been saying and prescribing to patients for the past 20 years.  (Vindication feels mighty fine):

  •  many people are suffering with gluten sensitivity without having celiac disease, and should avoid these foods for the betterment of their health
  • lots of good healthy fats will make you healthier and slimmer;  high-glycemic  carbohydrates and sugar are what make you fat
  • a sugar-free, grain-free diet for Type II diabetics is the best way to go
  •  physical exercise and mental exercise help your brain cells grow
  • cholesterol is a great molecule, don't diss it:  it's the golden goose for vitamin D, bile acids, neurotransmission, sex steroids, etc.
  • inflammation and oxidation are the culprits for many diseases, don't blame cholesterol
  • if you're going to take a cholesterol-lowering drug, you should know all of the facts, especially if you have never had a cardiovascular problem before
  • gluten, sugar and other pro-inflammatory foods, along with environmental toxins, can create the perfect storm that could lead to serious diseases
  • eating high cholesterol foods does not impact your blood cholesterol levels
  • the brain functions well on adequate levels of cholesterol and your brain loves fat
  • a high sugar and high carbohydrate diet oxidizes LDL, and that's what's bad about cholesterol, not the all-important LDL that transports vital cholesterol into your brain
  • lowering cholesterol will not prevent a heart attack
  • short-term water fasting is good for your brain and waistline
  • DHA is a stellar supplement as is coconut oil
  • having regular proper sleep each night is crucial for your brain and body to repair themselves

In his book, Dr. Perlmutter explains all of the above and so much more, with scientific studies that support these common sense statements.

Like this MD, and many of my colleagues, I too have witnessed dramatic, positive changes in many people with different types of health challenges, with the removal of gluten and sugar from the diet and the addition of large amounts of healthy fats.  However, Dr. Perlmutter also recommends a large volume of eggs to be eaten, but is careful to point out that any food can be an intolerance that can cause inflammation.

Case in point:  Three members of my family would love to put eggs back into our diets because of the health virtues ascribed to eggs as mentioned in the book.  However, we all tested very high positive for IgG4 levels to egg yolk and egg white and each time we would put this wonderful food back into our diets, we would collectively experience a wide range of varying symptoms including brain fog, fatigue, smelly sulphur farts, abdominal bloating and abdominal cramping:  definitely signs of low grade inflammation.

From what I have observed, the food that most frequently displays elevated IgG levels in patients' food sensitivity tests, is egg;  even more frequent than gluten, gliadin, and milk components.  However, I would guess that only about 20% of those who have elevated IgG levels to eggs complain about symptoms associated with eating them.  A large percentage do not notice any adverse symptoms when eating eggs but still test positive.  I have my theories about this, but it would only be speculation and not based on anything solid.

This is quite unlike the case for gluten and dairy though.  Of those that test positive for gluten and dairy, I would guess that at least 95% notice mild to dramatic adverse affects to their health with the consumption of these products.  About 5% say they observe no changes.

Dr. Perlmutter recommends having the comprehensive gluten sensitivity test done called Cyrex Array 3, and for other food intolerances like dairy, eggs, soy and other gluten grains, the Cyrex Array 4 test.  Tests from Cyrex Labs are not yet available in Canada, however, IgG4 and IgE testing of foods can be done by Meridian Valley Labs in Washington or Rocky Mountain Analytical (RMA) in Alberta.  I use the former, however the latter also gives an option for testing the IgA levels of foods.  RMA also states that, "it is important to know that, with the exception of gliadin (found in wheat gluten), the elimination of IgA reactive foods has not been proven to provide relief for any specific health conditions".  I see that Array 3 and 4 use IgG and IgA antibodies.

Personally, I only test for IgE and IgG4 levels to gluten and gliadin, but not for IgA.  Perhaps I will now start doing IgA levels in those people who believe gluten/gliadin is problematic but tests have previously shown negative for IgE and IgG4 to this substance.

Over the last year, our family has essentially gone grain-free.  We believe it is the next health echelon up from being gluten-free, sugar-free, dairy-free, alcohol-free, junk-free and egg-free;  which we have now been for almost 2 decades.

The reason we went grain-free was not because of Dr. Perlmutter's book.  (It had not yet been released).  Actually, my husband was having some digestive difficulty that was finally and accurately diagnosed as SIBO (small intestinal bacterial overgrowth).  This condition explained why he could not tolerate probiotics and why he had dramatic improvements in his health after an antimicrobial treatment coupled with a grain-free diet.  His sleep-related laryngospam completely disappeared along with other health issues.

In cooking a grain-free meal for my hubby, I wasn't going to cook a separate meal for him and a separate meal for myself. No way.  So I started going grain-free as well, not just gluten-free.  I also noticed further benefits with my own health.  Though I will say, twice per week we eat gluten-free grains in the form of home-made bread when we go up in the mountains on our 4 - 7 hour hiking treks.  There is no way that either of us could expend that kind of energy without a higher carb load intake during those days.  We don't consume grains for snowboarding or for 1 hour of basketball play, but for an extreme energy expenditure like endurance hiking, I don't see any other solution.  Nut and seed breads are far too heavy on both of our digestions, and I don't believe they would provide the instant glucose needed for our muscles to power up a mountain.  I could be wrong however.  Next summer I'll try powering up a mountain on only fat and protein and I'll tell you how it goes.  (I'll definitely have an emergency stash of dried fruit on hand just in case :) ).

IMNSHO (in my not so humble opinion), after Group Mountain Hiking, nutrition is the second best medicine!

So I've told you two reasons why I'm excited about this material:  1) many naturopathic doctors have seen similar positive dramatic health changes with the removal of sugar and gluten/grains from the diet with a concurrent increase in healthy dietary fat, and  2)  our family's personal success with this type of diet speaks for itself.

The last reason why I am excited about this material, relates to the fact that my mother died from a horrible neurodegenerative disease called ALS.  When I first got this book (like I did with his Better Brain Book), I immediately went to the index to look up all of the information he provided about ALS.  Within the book, there wasn't anything that I didn't already know:

  • there are situations where ALS has been wrongly diagnosed and the problem is really gluten sensitivity (how lucky for those folks!)
  • the disease is devastating and there is no meaningful treatment
  • a ketogenic (high fat) diet might be helpful
  • misfolded proteins might be part of the problem
  • a deficiency in glutathione-S-tranferase (an enzyme made from one of the most powerful detoxification molecules in the body) exists in many disease states including ALS
  • people with ALS who also have high cholesterol do better
  • oxidative stress is involved, as may be the glycation of proteins, lipids, DNA and RNA, and when the diagnosis is made, sadly the damage is done

That's about it.

The reason I am excited though, is the remote and potential possibility that ALS may be preventable.  It may not be.  But what if it was?

What if this disease is a disease that occurs because of a perfect storm, as I have hypothesized in my mom's case previously:  in her case, a neuro-vascular injury, long-term pesticide inhalation, long-term MSG ingestion, long-term gluten dietary habits, long-term low-fat dietary habits, low levels of estrogen and progesterone (? low cholesterol), and who knows what else?

I'm going to be really bold here and say that I believe ALS will eventually be cured or at least substantially ameliorated in my lifetime, but it will take 3 things:  1)  a drug to stop proteins from misfolding, 2)  stem cells to regenerate lost function, and 3)  integrative nutrient therapies to maintain that which will be achieved with drug and stem cell therapies, by addressing ongoing oxidation, glycation, and inflammation.

In ten years, I'll come back and read this blog to see how silly my above comments were, or how bang on I was.

This next part is for my children and my future grandchildren:

Big H and Little B:  listen up.  While your grandmother most likely did not have the type of ALS that is passed down to successive generations, you have a family history of various neurological illnesses, as well as a family history of sugar/grain related problems:  ALS, depression, stroke, brain aneurysm, diabetes type II and obesity.

I recommend that you both follow the website, DrPerlmutter.com, and read his book "Grain Brain", because I love you both, and I want the best for your health.  Prevention is much, much easier than trying to repair the irreparable.

If you read only one health book in your entire lifetime, let this be the one.

_________________________________________________________________________

Edited to add (Dec. 11/13):

Even though I have accounts in both, I don't care much for social mass media like Twitter and Facebook.  However, Pete thought this was cool and Hilary thought it was nice.  Me too!

Screen shot 2013-12-11 at 8.02.43 AM

Group Mountain Hiking is the Best Medicine

IMG_4928 We have all heard the following:

Laughter is the best medicine.  Happiness is the best medicine.  Knowledge is the best medicine.  Prevention is the best medicine. Nutrition is the best medicine.  Medicine is the best medicine.

I will now make the case for the best of the best:

Group Mountain Hiking is by far and away the best medicine on earth.

Yup.  This is a bold statement, I know.

Obviously, the type of medicine one uses, largely depends upon the condition that one is taking the medicine for, which ultimately determines its quality for achieving premier status as the "best medicine".  However, if I could pick just one therapy that would help the greatest number of people regarding preventive health and achieving optimal wellness, it would be group mountain hiking.

Let's first start off with science-based perspectives.

A 2012 study done in Austria, showed that group mountain hiking was associated with an improvement in hopelessness, depression, and suicidal ideation in patients suffering from high-level suicide risk.

If intense mental illness as seen in high-risk suicidal patients can be improved with group hiking, imagine what it can do for people who are feeling a bit blue or a bit stressed?

In a 2013 study, again done in Austria, suicidal patients who were hiking 2-3 hikes per week, 2 - 2.5 hours per hike for 9 weeks in a row, showed significant improvement in maximal exercise capacity and aerobic capability.  However, inflammatory biomarkers like cytokines were unchanged during this hiking experiment.  Cytokines are elevated in many disease states including suicidality, but at least these biomarkers did not worsen.

A third Austrian study in 2003, showed that people with metabolic syndrome (central obesity) who hiked for 3 weeks at a moderate altitude of 1700 m, not only showed the expected reduction in body fat and body mass, they also showed a stimulation of erythropoietin (EPO).  How about that?  A natural and legal way to blood dope in order to get more oxygen to all of the tissues.

And this last study, again in Austria, showed those with metabolic syndrome had physically adapted to moderate altitude (1500 - 2500 m) by displaying an increase in EPO as well as a shift in the oxy-hemoglobin curve to the right.  This means that there was improved oxygen transport to the tissues in these people.

Ya gotta love the mountains in Austria.

There is an undeniable association between exercise and great health.  There are oodles of scientific studies showing everything from being able to grow new brain cells with exercise, to being able to reduce the risk for developing some types of cancers.  And of course, the beneficial effects of exercise on cardiovascular health are well documented, as are the improvements in musculoskeletal flexibility, balance, and overall strength.

There is something called grounding, which is the contact of the human body with the surface of the earth.  A study called, "Earthing (Grounding) the Human Body Reduces Blood Viscosity - a Major Factor in Cardiovascular Disease'', shows that contact with the earth's surface can prevent the blood from becoming thick, as seen in atherogenic disease.  Less viscous blood means better oxygenation to all of the tissues in the body.

During mountain hiking, there is constant contact with the earth:  hiking poles digging into the earth with each footstep on the ground;  hands touching rocks in order to balance over scree;  and hands grabbing for branches and trees when necessary.  Mountain hiking is the most supreme form of grounding.  Oxygenation, oxygenation, oxygenation.

Even though I could find no affirmative studies showing the beneficial effect of negatively charged ions in fresh air on health, there must be something in mountain air to give one the experience that John Denver describes as a Rocky Mountain High.  It must be more than just natural blood doping in the brain created by an increase in EPO, that gives one a natural high.  It must be more than just the increase in feel-good chemicals like endorphins and enkephalins typically seen with exercise in general, that gives one a natural high.  There must be something special in mountain air . . .

IMG_5548Of course there are risks associated with mountain hiking:  bears, cougars, dehydration, exhaustion, hypothermia and injury.  For the most part, all of these can easily be mitigated with preparedness and awareness.

From an anecdotal point of view, this is what I can tell you regarding my own experience and what I have heard others say:

Group mountain hiking is the greatest reliever of stress that exists.

The socialization aspect of this activity helps improve mental health.  Hiking with people who love the same activity, stimulates connection, laughter and communication.  Socialization while walking, lightens the load and keeps us light on our feet. IMG_5539

Group mountain hiking also provides for long periods of quiet meditative silence, where each step, step, step, personally takes me deeper into myself and deeper into my surroundings.

Each step, step, step, is a walking meditation that releases every morsel of held-on tension in my body, directly into the earth.  Each step, step, step, releases every stress-filled thought entwined in my brain cells, directly into the air and trees that kiss my skin.  And when the last bit of stress trickles out into my sweat, it is the mountains that surround me that can bare any further load I give up to it.

DSC04236Thank you Mother Nature for embracing our woes and tensions.

After one of our usual 4 - 7 hour hikes that typically consists of elevation climbs between 500 - 1300 meters, I remember one hiker telling me that the stress release he experiences keeps him going for about 4 days, after which point he starts to come down from his high.

During times that I am not experiencing any challenging stresses in my life, I'm pretty much on cloud nine the whole trip.  At other times, if I have been extremely stressed during the week, it takes about 1 -2 hours of step-step-stepping, going up-up-upward into the mountains, where Mother Nature cleanses my soul.  After that, I can relax into my usual mountain high experience.

IMG_5492Finally, for me personally, group mountain hiking is the most wonderful family experience that I partake in.

Group mountain hiking is indeed the best medicine!

Thank you Mother Nature for your exquisite display of beauty.

I rest my case:

[youtube=http://www.youtube.com/watch?v=8wohIH9DWI4&feature=youtu.be]

Useless Drugs

UnknownThis is not a blog about the pitfalls of Big Pharma. I'm not a conspiracy theorist that believes the pharmaceutical industry is only a money making machine that does not care about the health and lives of the people it is manufacturing drugs for. And I am not a person who tries to avoid pharmaceutical drugs at all costs. There is a time and place for pharma drugs; in situations that could mean the difference between life and death; in situations that could mean the difference between suffering and a good quality of life.

Those types of drugs are not the subject of this post.

The useless drugs I am referring to, are those that continue to be prescribed by physicians for no good reason.

The following is an example of one of these useless drugs.

In a non-emergency condition, when a physician tells you that you will ________ unless you take a certain drug, ask your physician to show you the evidence of his/her statement. Fill in the blank. You will: die, or lose your kidneys, or have a heart attack, or have a stroke, etc., etc.

The stimulus for this blog came about from an interaction I had last week with a primary care physician. His patient with early stage dementia (possibly vascular in origin), was taking a cholesterol lowering medicine called Ezetrol. The patient was intolerant to statins, - drugs that are seen to be the gold standard for hyperlipidemia, - and thus he prescribed the useless fibrate drug, Ezetrol.

I was aware of the non-efficacious data regarding fibrates, so I encouraged the patient to discontinue the drug because I was very concerned about lowering cholesterol in a person with a neurodegenerative (maybe neurovascular) disease.

I was concerned, because I follow the work of neurologist Dr. Perlmutter, who wrote Grain Brain.  His views on cholesterol and neurodegeneration make common sense. Cholesterol is linked to improved memory, concentration and learning. The brain consists of 25% fat, and cholesterol is crucial for the manufacture of cell membranes and neurosteroids, which are essential for synapse formation, maturation, and nerve transmission. In short, cholesterol is crucial for proper brain wiring. Cholesterol helps ensure that the lights are on and somebody is home.

Having had a mother who succumbed to a neurodegenerative disease, and knowing that treatment and cure for most neuro-degenerative diseases are minimal to non-existent at present, I take brain nutrition and brain fat very seriously. Cholesterol lowering drugs in these patients make absolutely no sense. I am aware of the potential studies regarding Alzheimer's disease and statins, and if these drugs prove to be efficacious, they will not be as a result of their lipid-lowering effect, but because of their ability to alter blood viscosity and improve oxygenation in the brain. That is my predicted opinion.

Back to the story.

This physician told the patient, that if the Ezetrol was discontinued, a fatal stroke could follow.

I called up the physician to discuss the matter, and in an authoritative and arrogant tone, he said this to me:  “Ezetrol in a statin-intolerant patient with hyperlipidemia who has had previous strokes is proper standard of care”. He added, that it would be “medically negligent to discontinue the drug” because it was “preventing this patient from having a fatal stroke”.

Either this physician was not up to date on the available data, or there was new information in the world of cholesterol lowering drugs that I was not aware of.

I sought out information from the evidence based drug therapy site called Therapeutics Initiative (TI). From the meta-analysis of randomized controlled trials, a paper entitled Serious Adverse Event Analysis:  Lipid-lowering Therapy Revisited states, "analysis of SAEs (serious adverse effects) and mortality does not support the use of statins for primary prevention or the use of fibrates for primary or secondary prevention".

This means that a drug like Ezetrol has zilch benefit, and in fact, people on fibrates have a 1 in 200 chance of dying from a non-CHD (coronary heart disease) cause while on the drug.

I contacted a doctor who was previously involved with TI, and he informed me that using fibrates was not standard of care.

Whether it was “proper standard of care” or not, didn’t matter much to me. After all, I was part of a profession where there are no naturopathic-specific standards of care, and I knew that “proper standards of medical care” do not always address the health needs of all people. One size does not fit all.

However, I was very concerned about his bold statement of medical negligence and his unwavering belief that this patient would indeed be harmed by depriving her of a necessary treatment. I was of a different opinion, and believed the exact opposite:  this drug could potentially be harmful for this person, with zero benefit regarding stroke prevention.

I looked further to see what evidence there actually was, and all I could come up with was a recent study entitled, "Lipid management in the prevention of stroke:  a meta-analysis of fibrates for stroke prevention".  One of the concluding statements in the abstract states,

Our study indicated that fibrate therapy might play an important role in reducing the risk of fatal stroke in patients with previous diabetes, cardiovascular disease or stroke.”

However, when you look at the numbers in Table 3, the above concluding statement is, well, . . . hogwash. In what universe where you have a P value of 0.26, can you make any efficacious concluding statement about secondary prevention and fatal strokes? According to that study, the best you can say, is that you think fibrates change the risk of stroke somewhere between a 77% decrease and a 47% increase, so what you are actually saying, is that there is no difference, and that any difference is due to random chance. Thus the null hypothesis is accepted and this drug is one big DUD.

A paper entitled, “How confidence intervals become confusion intervals”, clearly shows how clinicians must be able to interpret and understand confidence intervals than just rely on (false) conclusions made by the authors of a scientific paper.

Next time your doctor prescribes a pharmaceutical medication for you and you are reticent about taking it, ask your PCP to guide you to the evidence that supports his/her position.

Next time your doctor delivers the threat of illness or death upon you if you do not abide by a certain treatment or procedure, ask him/her to guide you to the evidence that supports this position.

Coincidentally, one would think I had a vendetta against Ezetrol, since I described its uselessness in this blog awhile back, where the drug caused a nephrologist to falsely believe that his patient was in progressive renal failure.

Drugs are useful when used wisely.

Incomplete Medicine - Why I Became a Naturopath

imagesOver the past 2 decades, I have been asked why I had gone into naturopathic medicine, especially after having worked as a critical care nurse in a teaching hospital, and after having taught critical care neurology to registered nurses at a local college. In essence, people were asking me:  why did I venture on to the dark side? – or into the light? – or to whatever? - depending on your own point of view and your own belief systems. Why the switcheroo? Many people over the years have wondered and asked me this.

I didn't see medicine like that back then, that is, black and white;  polar opposites.  And I don't see medicine like that now.  Medicine is medicine;  whatever improves the health of a given individual, both objectively and subjectively, where there is both a short-term and long-term increase in the quantity and quality of life.  That's what medicine is to me.

Conventional medicine is good medicine. Sometimes, it's exquisitely fantastic medicine. Unfortunately, at other times, it is medicine that sucks big time, and causes unnecessary harm. However, all in all, on the average, it's good medicine.

But it is very incomplete medicine.

Why am I even bothering to write this blog (other than for my own posterity)?

Because just the other day, when it was too damn cold and too damn wet to go on a day hike up in the mountains, I decided to surf the internet instead. So instead of engaging in healthy behaviour for 7 hours, I wandered onto the SBM (Science Based Medicine) site and engaged into 7 hours of unhealthy masochistic reading. Well, I did learn a few useful medical information tidbits while reading some of the articles on the site, but for the most part, if you are a naturopathic physician and would like to read all of the reasons why you are a dangerous, useless, redundant, scum of a scam artist, then head over to the SBM site and get your dose of toxic brew – you know, the kind of brew that contains “unnamed”, “bogus”, “illusionary” toxins.

So my story goes . . .

Back in my teens and 20s, I experienced chronic headaches, fatigue, dysmenorrhea, intermittent abdominal pain, mood swings, depression and severe PMS. I was on the birth control pill for 7 years, which helped my dysmenorrhea, but aggravated most of my other symptoms. By my mid-20s, I developed frequent episodes of a pinpoint macular rash on my soft palate that was always followed by an acute bronchial infection. These frequent episodes of acute bronchitis laid me out flat for 3 weeks, 4 – 5 times per year. This had been going on for 2 years, and for each acute bronchial infection, my GP prescribed an antibiotic. My headaches became worse, my fatigue became worse, my moods became worse, my infectious episodes persisted, and then I thought, THIS SUCKS.

At that time, I was working in a fantastic hospital in Ontario, with all of the latest and greatest technological medical advancements. I witnessed incredible life-saving treatments while being an integral part of a life-saving critical care team, and yet when it came to my own health, I felt like shit most of the time.

How was it, that the medicine I was an integral part of, was so good for so many people (for the most part), yet this same medical way of approaching health, couldn't do a damn thing for me?

It was at that point that I saw a naturopath. I became well. I learned what good health meant. And the rest is history.

This was reason number one for the “switcheroo”.

Around the same time that I started on my road to wellness, while working in the ER, ICU and CCU, I saw the same people coming in over and over again: patients with bleeding eosophageal varices from alcoholism, patients with bleeding ulcers from NSAID abuse, patients with suicide-attempted overdoses, obese patients with recurrent heart attacks, etc., etc., etc., etc.

I wondered to myself, surely, these types of conditions can be prevented or ameliorated, long, long before they reached the critical breaking point that necessitated medical heroic intervention? Surely? These were the types of questions I was asking my colleagues at the time.

“Shit happens”, was the answer that some of my colleagues gave me. I thought about it. For sure, when an idiotic drunk driver wiped out an innocent family and I was in the ER pumping on the chest of one of the family members as a last ditch rescue effort - yeah, for sure. Shit happens.

But some "shit" can be turned around. Can't it? Lots of "shit" is preventable. Isn't it? After all, I was feeling like shit, and I regained my health, so why couldn't others do so as well? I started studying university biochemistry, physics and physiology for my pre-med entrance into naturopathic medical school, and at the same time I started learning about preventive health, far beyond the minuscule amount of information I had learned in nursing school.

That was reason number two for the “switcheroo”.

Around the same time that I started experiencing much better health and wondered about better health for others, I saw an overweight 34 year old woman in ICU, after what was suppose to be a routine gallbladder operation (an open cholecystecomy at that time). The surgeon accidently cut something he wasn't suppose to. (I don't recall now, 30 years later, whether it was the common bile duct, hepatic duct, hepatic artery, or what was accidently cut). All I remember was that an otherwise “healthy”, overweight young woman, walked into the hospital for a routine GB operation expecting to be home recuperating after a week, and instead, ended up septic in the ICU. For months, nurses changed and irrigated her open wound dressings that were continuously exuding pus from the visible intestines below. She eventually died in ICU.

Whoa. Shit really does happen. Yes, sometimes even the best and most skilled surgeons make accidental mistakes. But I asked myself back then, could her death have been prevented by the idea that a cholecystecomy should be used as a very last resort treatment option instead of a first line of attack in an otherwise stable patient with mild symptoms?

That was reason number three for the “switcheroo”.

Colleagues at the hospital I worked at, were mostly supportive of me taking the step toward the world of natural medicine.

The last and final reason for my “switcheroo” delved into the world of woo – the bane of all rigid SBM scientists.

A 36 year old pregnant patient of 30 weeks gestation with her second child, was admitted to ICU with a severe kidney infection. She rapidly deteriorated to the state of being comatose, despite being given multiple intravenous antibiotics to help reverse her disease state. She went into premature labour at 32 weeks gestation in the adult ICU. The Neonatal ICU team came down and delivered a healthy preemie that needed constant monitoring in the NICU which included gastric tube feedings.

Mom and babe were now separated: mom in the ICU on the second floor, and babe in the NICU on the fourth floor.

At this point, the mother was on a ventilator and started having cardiac arrest after cardiac arrest. This went on for the next 4 - 5 days. “Code Blue” was called on this lady at least 7 times, and on some occasions I remember CPR being done on her for 30 - 40 minutes at a time.  Multiple regimes of the same heavy duty intravenous antibiotics continued to be administered despite her progressive deterioration.

This woman was in septic shock, her heart was failing, she was in multi-system organ failure, she was in a vegetative state, the drugs and CPR were barely keeping her on this side of the precipice, and none of us – not doctors, not nurses, - not one of us believed for a moment that this woman would not succumb to her illness or progress to a persistent vegetative state since the antibiotics were having no effect on her septicemia.

It was at this point in time that a nurse from NICU came up with the brilliant idea of bringing the baby and the incubator down to the adult ICU, to touch her dying mother. The nurse placed the baby on to her mother's belly.

I was amazed with what happened next.

This mother, who we all believed to be brain dead - (if I recall correctly, a BSEP done at that time showed no brain activity), - this mother started to have tears running down the sides of her face when the baby was placed on her belly and she slowly started to regain consciousness.

Over the next few days, as the baby was brought down to her everyday from NICU to lie on her belly, she regained her health to the point that after a few weeks, she was wheeled out of the ICU in a wheelchair with her baby in her arms.  Both were now ready to go home from the ICU.

This isn't only a story about the incredible power and efficacy of conventional medicine. This is also a story about something bigger than medicine. It's the story about some incredible force – life force, love, limitless energy – call it whatever you want, but to me it was the story of something much bigger. Spontaneous healing? Placebo response? No.  Even though it was intangible, it was more powerful than these common notions that allude to mere coincidence and wishful thinking.  And it was definitely something that couldn't be measured or quantified by a randomized clinical trial.

After that, I wanted to expand my understanding of health and healing, so I entered naturopathic medical school in 1989.

While experiencing my acute bout of temporary masochism a few days ago, I ran across a few articles written by Dr. Harriet Hall, a retired MD who speaks out against complementary medicine, integrative medicine, naturopathic medicine, acupuncture, etc.

In her article called Answering Our Critics, Part 1 of 2, Dr. Hall lists her answers to 30 criticisms hurled at the rigid SBM folk. I can't say I disagree with any of her answers except for this one:

  1. It worked for me.Maybe, maybe not. You can only know that you improved after the treatment; you can't know for sure that you improved because of the treatment. That could be a post hoc ergo propter hoc logical fallacy. You may not be able to imagine any other possible explanation, but that doesn't mean there isn't one.

Apparently, Dr. Hall has never met my brother Peter Savich and his MOFD (“My Own Freakin' Data”) theory. :)

In her follow-up article called Answering Our Critics, Part 2 of 2, she lists 6 more rebuttals to her critics, writes a blurb about placebos, and states her own belief about acupuncture:

What does “effective” mean? It's important to understand the difference between objective outcomes and patient perceptions. We can conclude from the evidence that acupunture is merely a theatrical placebo. We can conclude that it would be unethical for us to recommend it. But if a patient is already using acupunture and feels it is effective in relieving his symptoms, that falls into the category of comfort measures, where the patient is deriving a degree of comfort from a procedure with no objective effects.”

Apparently Dr. Hall has not read this particular study on acupuncture and depression.

All in all, for the most part, I would agree with her rebuttal points from 31 – 36, but I do take issue with #35:

  1. Conventional medicine doesn't have an effective treatment for my disease.

    CAM (Complentary Alternative Medicine) doesn't either. They may tell you they do, but they will only offer false hope and waste your time and money. Maybe it's time to accept that there is no effective treatment and concentrate on finding ways to cope and improve your quality of life.

     

And this is where I struggle to understand the rigidity of these MDs, including only a very small minority (thankfully) in my own community. They believe they have this foreknowledge for each and every individual person, that because a treatment has not yet been proven through the gold standard blinded RCT (randomized control trial), that the patient must accept that there is nothing available or of value to him/her because a particular treatment has not yet been clinically proven via this gold standard. How then, does one find ways to “cope and improve your quality of life”, as Dr. Hall suggests?  My answer is naturopathic medicine.

Had I believed my medical doctors when I was in my 20s, when they said to me: “there is nothing more that can be done for you”, my health and my life would not be what they are today. Had I listened to my pediatrician when she told me that I would have to “accept the fact” that my child would have lifelong respiratory illnesses and other infections, her health and her life now would not be what they are today.

What I struggle to grasp, is why, when rigid MDs are faced with a patient who continues to suffer, and then becomes well after seeking CAM therapies, believe it to be more important for that particular patient to follow a specific set of evidence-based medicine rules, instead of acknowledging that for this particular patient, there may be helpful answers that reside beyond the rigid science box for whom conventional medicine had no answers. Then what typically follows, is a circular conversation about efficacy regarding spontaneous healing, placebos, empirical observation and MOFD, and the value or lack of value of the latter two, for those who suffer and find no relief with conventional therapy.  However, circular conversations get us nowhere, so I will stop right here.

What is more important? Compassion or rigid science? The SBMers will say that rigid science is the epitome of compassion because newly discovered medical treatments will be of benefit to (hopefully) a majority of people. The CAMers will say that compassion must be all-inclusive right now, not just for those whom conventional medicine has been successful, but for many who have been met with its lack of efficacy.  In my opinion, both points of view are valid and are not mutually exclusive.

I will say though, that one size does not fit all. It never has, and it never will.  That, is what personal trial and error is all about, in the face of limited or no scientific proven data, and in the face of vast volumes of empirical observatory data.

Conventional medicine is good medicine, but it is incomplete medicine. Naturopathic medicine expands the possibilities for many who have not yet found answers to their health challenges.

My Two Sherpas

IMG_1775 Well, they aren't really my sherpas, but they are the most stellar daughters I could have ever asked for.

I haven't been physically fit for the past few years now, mostly due to sports injuries as well as to my neglect to make time for rigorous physical activity. My multiple excuses have continually trumped my desire to engage in prolonged rigorous exercise, and therefore the latter has not seen the light of day as a priority in my life for the past 5 years.

However, in the last three days I went on two hikes; Harvey Mountain and the Little Onion.

For the Harvey Mountain hike, I trekked with a group of women known as the Friday girls. This group consists of women in their late 50s, 60s and 70s. These young chicks scurried up the mountain like mountain goats. Unbelievable. They were all in tremendously excellent physical condition, and clearly lived by the Bulkley Valley Backpackers motto: “We don't stop hiking because we get old. We get old because we stop hiking.” Each of these women had a joie de vivre with every boot step up the mountain, and each had the enthusiastic laughter of a young child with every step down on the descent. I'm sure the negative ions in the mountain air contributed to their zest for life and for outdoor activity.

Driftwood Mountain043Driftwood Mountain022I was nervous about going on these hikes for many reasons. It may have seemed odd to my sherpas that I was so nervous, since I had hiked Harvey Mountain many times in the past;  the last time being almost 5 years ago with my sister, brother, brother-in-law and husband.

And the last time I hiked the Little Onion was with my brother Peter and it felt like an easy walk in the park. So why the nervousness?The Onion Kathy and Pete

Well, the old grey mare just ain't what she used to be. Slower, creakier, stiffer, and older.

Unknown-2

My joints and muscles for steep mountain trekking hadn't been lubed up for the past 5 years, and to compound matters, I had experienced severe acute peri-menopausal blood loss for 18 days just prior to the hike which left me completely drained. However, thank goodness for intravenous multi-vitamin and mineral boosts, healthy veggie smoothies rich in necessary nutrients, and naturopathic medicines in general!

Even though I was really nervous, I had already made up my mind to shelve all of the excuses that normally rolled off the tip of my tongue and brain for the past 5 years.  I decided to at least attempt the hikes, whether or not I was eventually successful in climbing these mountains remained to be seen.

Anyway, back to my stellar sherpas.

Hilary, my almost 28 year old daughter, supported and helped me throughout the Harvey Mountain hike. Bibby, my almost 20 year old daughter, supported and helped me throughout the Little Onion Mountain hike.

While going up Harvey, Hilary walked by my side every step of the way. When I fell far behind the rest of the pack, going ever so slowly, and wondering if I could take another step because my heart and lungs felt like they were surely going to explode, in the most gentle, calm and loving tone, Hilary kept on saying to me, “You can do it mom, this will help you get into shape, go as slow as you need to go, because you can do it”.

On the descent, my muscle fatigue got the best of me and my legs started to violently tremble at the same time the weather decided to unleash its downpour. My legs were so weak and achy that crawling down the mountain the rest of the way on all fours seemed like a great idea at the time. Hilary stepped up to the plate again, and with her calm and loving encouragement, offered to take my backpack and said, “You can do this mom, we're almost there. You just need to get into better shape and you'll be doing this easily”.

While going up the Little Onion, again, I was nervous about my ability to hike the mountain. My aching muscles from the hike two days before, along with the sensation of my potentially exploding heart and lungs during relentless steep climbs, left me wondering whether I should turn back and call it a day. After all, the rain during that hike was unforgiving and showed no signs of letting up.

DSC_1252My other sherpa Bibby, with both arms held high in the air and with the enthusiasm of youth, cried out, “Mom, you've got this. You can do it!!!!” As I fell far behind the group, she too, stayed by my side every step of the way.

According to the Merriam-Webster dictionary, a sherpa is “a member of a Tibetan people living on the high southern slopes of the Himalayas in eastern Nepal and known for providing support for foreign trekkers and mountain climbers”.

While Hilary and Bibby are not Tibetan nor am I a foreign trekker, these daughters of mine provided the much needed support, love and encouragement that I needed to accomplish what I set out to do on these treks. I could not have done it without them and I am so very grateful that they helped me rise above the Land of Excuses and into the Mountains of Bliss.

Thank you girls. High fives all the way around.

I love you.