Monday, April 11, 2016

Using your voice in medical/healthcare situations

I'm about to share a personal story with you. It might seem like a little too much information, but I'm doing so for an important reason. Today's post is about the importance of using your voice with anyone giving you medical attention (doctor, nurse, technician, etc) and standing up for yourself.

I recently have been experiencing abnormal cyclical pelvic pain. Knowing I needed a requisition for imaging and labs (blood work), I made an appointment with a medical doctor (MD). She was extremely nice, asked all the "red flag" questions and agreed that imaging would be necessary.

One quick thing I will bring up though is how Ontario's medical system - although effective at screening for emergencies - was disappointing. As a naturopathic doctor (ND) I've become accustomed to spending great amounts of time with my patients. And when it comes to female reproductive health my screening goes beyond the basics and into a full history with details on everything including family history, age of menarche (first period), history of symptoms, and flow assessment (colour, clotting, volume) and so much more. My time in this particular visit was limited. I felt like I kept cutting the MD off because I had additional information that I thought she would find helpful.

I guess it's a moot point because having the imaging and testing done was the most important thing to me. I just found it was really difficult to be heard in such a short amount of time. Where this would be more troubling for me is if I was counting on the MD for treatment. Depending on my results, I'll likely get stuck in a one-size-fits-all model, be prescribed hormone replacement (birth control pill) and that will be it (luckily I know I have so many other options!) unless a referral to gynaecologist/specialist is warranted.

Again, a moot point, I got what I needed and went and had both a pelvic and trans-vaginal ultrasound done. Upon doing the pelvic ultrasound the technician mentioned he could see a cyst. I told him another technician found something similar about a year ago but said it was just the remnants from a ruptured follicle (from ovulation). He said, no, that's not what this is. He continued to tell me that this is likely what's been causing my pain, and asked if I still wanted to do the trans-vaginal ultrasound.

Hold up right there. Red flag #1: I have no idea if this guy was a doctor. I'm almost certain he was only a technician. He has a requisition from an MD requesting both types of imaging be done and now he's asking me if I want to have one of them done - based on what he thinks is causing my pain? How many other people have been asked a similar question and have said "Oh, if you think that's what's going on, then maybe I should save myself the inconvenience and not go through with the trans-vaginal exam."? I was floored. So I stood my ground, "No, I'd like to have it done as well. I need to rule out other issues and pathologies that might also be going on."

Although he maintained professionalism during this next part of the exam, his communication was terrible. Again, lucky, being an ND and a previous gynaecological model for medical students, I've had a lot of experience with pelvic examinations and having to communicate direction and instructions.

I knew there was a problem when his initial attempt on placement of the ultrasound wand was way off. I thought, Okay, he's a technician who does this for a living. He must understand female anatomy and know how to troubleshoot in order to obtain the necessary images. So I offered direction and used anatomical description and direction to help him out. Red Flag #2: this guy doesn't know what "anterior" means... at all.

So as I'm describing how he needs to shift the position of the ultrasound wand, I realize he truly doesn't understand and now I'm very much uncomfortable and almost in pain, so I intervened, and changed the placement of the ultrasound wand myself.

Again I wondered, If this was anyone else on the table, would they have spoken up? How long would they have put up with this ... 'misdirection' before saying something? If I had been a teen, I probably wouldn't have said anything because you always think that grown-ups in the medical field know everything, Maybe that's how they do it? I don't know!

This isn't going to happen in every case, but there are lots of people in the medical field who have less experience, terrible communication skills and lack a good bedside manner. It's not everyone but it can happen anywhere.

My point is, no matter who is treating you or giving you medical attention, don't be afraid to use your voice. Speak up and stand up for yourself. If you want something, ask for it. If you feel pressured into a decision, ask about the risks and benefits of ALL available options. If something doesn't sit right in your gut, trust your judgement. And don't ever feel like you're a burden just because your doctor or technician is rushing you. That's them rushing - their issue - you pay for healthcare through your taxes, so make sure you're getting what you need.

Monday, March 28, 2016

What every girl and boy needs to be taught before the age of 10

I read this amazing article the other day from the Huffington Post on "The Thing All Women Do That You Don't Know About." I had almost forgot the crucial difference between what is considered "normal" and "common". I took a moment to think and reflect about how I had been awkwardly and embarrassingly treated by boys in my past; Something that is common, but that should not be labeled as "normal" male behaviour.

There's a moment when a guy does something inappropriate that makes your skin crawl. Getting my ass pinched this weekend by a man who wasn't my fiancé brought on that feeling and I had to go back to my reflection of the article.

Recently there was an "uproar" in Ontario due to changes in our sexual health education. Some believe that kids in grades 1-6 are just too young to learn about sexual health and sexual behaviour. Today I wanted to share a personal story on why teaching our kids the difference between appropriate  and inappropriate (sexual and otherwise) behaviour is so important:

When I was in grade 7 (around 12 years old) I found a note in my desk from a boy I was told had a crush on me. Now, I had seen this before - or so I thought. In grade 4 a shy boy in the class had left me a note in my desk asking me if I'd be his girlfriend, followed with the options: Yes? No? Maybe? And I was to circle one and give the note back to his best friend. It was cute and harmless, and my naive 12-year-old self thought this would be similar. It wasn't.

I opened the letter and it was not what I expected. I was reading a full page (front and back) of this weird dialogue of all the things this boy wanted to do to me; mostly sexual things - some things that I didn't even understand. I actually had to ask a friend what he meant by "cat" - the sentence implying he wanted to fondle and touch my vagina.

I felt like a stone had dropped into my stomach. I felt weird and uncomfortable and I knew right away that it was wrong. I knew I needed to report it immediately.

That recess I took the letter straight to my grade 7 teacher as my so-called friends laughed and said, "You're actually taking that to the teacher?! You're going to get him into so much trouble!" and, "He was probably just messing around." I stuck to my guns - yeah, of course I was going to turn it in. I knew it wasn't right and I never wanted to receive a letter like this again.

My teacher started to read down the page and her face went from caring and smiling, to concerned, and then to something I've never seen from her before. It was like internal rage. I could almost feel her blood boiling as she kept reading. She kept composed as she thanked me for bringing this to her. She said it must have took a lot of courage but that I had done the right thing. She then told me she would take care of it and would come talk to me later.

She approached me shortly afterwards, asking that I come back to the classroom. I walked in the door, the room empty except for her and the two boys that had written the note (one had written it, the other was his "accomplice"). Both of them looked like they had just shit their pants. You don't see 12-year old boys cry very often, and these two were on the verge of loosing it (rightfully so). They knew the severity of the situation and had to apologize with my teacher there as a witness. As a kid, when someone says "I'm sorry" my usual response was "that's okay" - to which my teacher immediately said "No, it's not okay. You can accept their apology but it is definitely not okay."

From there, through high school, university, and even now, I get super irritated and annoyed with unacceptable dumb male behaviour. I don't know how else to describe it. Repeatedly getting honked at while I'm walking down the street, or whistled at, having my ass slapped or pinched. Walking down the hall at high school while a group of 3 teen boys exclaim at me, "Those are the biggest jugs I've ever seen!" - true story. I was horrified. 17 years old with DD's on my chest getting hollered at on a regular basis. In that moment, in the hallway, I made the split decision: I could have punched him in the face or said something - but what would I even say? My brain couldn't process what had just happened fast enough. And if I punched him, well, then I'd be in trouble. So I ignored them and walked away. But that memory and those feelings never left me.

I encourage you to teach your children when they are young: what is acceptable and what is absolutely unacceptable and not tolerated. Boys need to understand that woman are not objects and we don't deserve to be subjected to idiocy just because they're having some sort of urge. Girls need to be taught NOT to shrug this off or ignore it. You are also not "tattling" by reporting it. Truthfully, reporting it might not do anything at all, but you might also be very lucky and have someone, like my grade-7 teacher, who will stand up for you and make it known that this is not acceptable.

This topic isn't even geared at any specific age, but to all human beings. Old men molest toddlers and small children. Middle-aged women get cat-called and sent inappropriate sexual messages on by teens. There's been an increased awareness on this topic because I think most females have just had enough. I'm calling on you to educate your children. Don't be afraid to have these talks. And hopefully the next few generations of human beings will have less incidences of this ridiculous and unacceptable behaviour.

Thursday, March 24, 2016

Is a Type-A personality the new silent killer?

Working Hard
We all have to work at something: bettering ourselves, pushing our careers forward, investing in our relationships, building or "fixing" our homes, taking care of others to help them learn and grow, and reaching our own goals (in addition to making new ones). Sometimes it can be energetically or physically draining, but hard work can go a long way.

When we're just starting out in our careers it's important to keep busy and to put in the time. With anything, it's easy to sit around and do nothing - TOO EASY. Having that motivation and discipline to work hard at something is how we get ahead. Want to get into shape? It's not going to work if you decide to sit on the couch instead of moving your body. Want your business to soar? Having a Facebook page or website isn't enough, we have to hustle, we have to work on projects, make connections, get our names out there.

I wanted to bring awareness around overexerting ourselves. Many of us Type-A personalities love getting stuff done and controlling the organization of it all. We like the final "product" to be perfect, we create our own deadlines, and we can be competitive (either with outside competition or just ourselves).

Some of us really like staying busy. Maybe we work better with the pressure or get bored if there's nothing that needs our attention right away, so we seek more work.

It doesn't really sound bad, does it, being productive or overly productive? It's all in how we handle that much work and if we can achieve balance in our lives. For example, there have been some claims regarding the increased incidence of anxiety, increased stimulant use (including caffeine) and cardiovascular disease in those with Type A personalities. This isn't really far-fetched. We use coffee and other stimulants to keep us going everyday. Remember The Wolf of Wall Street? They used cocaine to wake them up and keep them sharp for such a high-pressure position.

Anxiety, Stress and Cortisol 
If we start feeling anxious about deadlines or time crunches, or if we're always in GO-GO-GO mode, this is where our health can start to suffer. Increased feelings of anxiety go hand-in-hand with the "fight-or-flight" response: it's your body's way of dealing with stress, and it's pretty awesome. We need this stress response, but if we are chronically in that state, our body can get tired from being "on guard" all the time.

Cortisol, the main hormone released in this stress response helps your body's efficiency for "fight-or-flight". Cortisol is also important for helping regulate blood sugar, blood pressure and your immune system. The idea is that cortisol comes in when you need it and then after the stressor is gone, the body recovers and is ready for the next "attack".

With chronic stress, we are constantly pumping out cortisol, so much so that our adrenal glands can't keep up with the demand. We also stop responding to those same amounts of cortisol. Your body wants the "fight" to be over so that it can repair, balance and be prepared for the next "attack". Without this recovery phase, it's very easy to experience Adrenal Fatigue (chronically low levels of cortisol).

Adrenal Fatigue and un-regulated cortisol can affect your sleep, blood pressure (feeling light-headed when you stand up), your mood, you may crave salt, feel tired (especially upon waking), have blood sugar crashes, brain fog, and get sick often.

When stress runs our lives, we can be more susceptible to cardiovascular disease, diabetes, depression, anxiety, chronic fatigue, infertility, menstrual dysregulation, hypothyroidism. Yes, that's right, your adrenal function is very closely related to your thyroid and sex hormone regulation!

You might feel great now. Maybe working really hard keeps your even more motivated and you feel super accomplished. Those 4-6 hours per night of sleep are enough for you and you're getting stuff done! But this won't always be the case. Our bodies always catch up with us and although you're functioning fine now, you may burn-out a few years down the road, or feel quite debilitated. This is often the pattern I see in Chronic Fatigue Syndrome patients: previously type-A personalities who after 10-20 years have completely burnt out and their body can't keep up anymore.

What's important is the balance: avoiding being overworked by allowing the body to recover. How can you do this?

  • Set boundaries for work: This will look different for everyone but may include putting your phone away or not answering emails for 1-2 hours in the evening (or as soon as you walk in the door!). 
  • Eat slowly and healthily: Don't eat on the go, or rush your meals. Take the time to enjoy your food. Anxious, stressed or rushed eating will impair digestion. When your body is handling stress it sends all its energy and focus to other places in your body - and away from your gut! Limiting consumption of sugar and processed foods will also help decrease inflammation in the body. 
  • Limit or eliminate stimulants: Caffeine has been shown to increase cortisol; But you can't use what you don't have (see my post on why coffee might not be working for you). Caffeine can also promote or increase anxiety. 
  • Get enough sleep! Your body needs to relax, recover and repair. 
  • Supplement support: 1000mg of vitamin C per day can help support your adrenal glands. You can also talk to your naturopath about which adaptogens (botanicals that support adrenal function and cortisol) would be best for you.
  • Give yourself time to relax: Yoga, non-cardio exercise, colouring, working puzzles, playing games, take a bath, get a massage. 
  • Seek counselling: Sometimes it's nice just to talk to someone, to get things off your chest and to pick up new tools on how to manage stress. 
  • Remember to breathe: Remind yourself throughout the day to take a few deep breaths. We tend to have very shallow breathing, especially when stressed. Take a nice big slow cleansing breath to relax the nervous system.

Monday, March 14, 2016

10 ways to avoid catching colds and flus

It's that time where we all seem to be sharing our lovely germs. The common cold, flu, bronchitis, sinus infections, ear infections... they're everywhere!

So how can you prevent yourself from catching them? Here are a few tips to ward off those illness-inducing viruses and bacteria when everyone else around you is sick:

1) It goes without saying, but I'll do it anyway: Hand washing. If you shake someone's hand out of politeness, make sure you wash those hands before eating anything, touching your face, or shaking anyone else's hand.

2) In reference to #1, wash your grocery produce. Now imagine all of those people who all shook hands, or who touched a door handle that were sick and now they're at the grocery store picking up tomatoes and testing them for firmness (because that's just a thing we do). Give that tomato a nice thorough rinse with water before cutting into it and adding it to your plate. This can eliminate up to 98% of bacteria on the surface of your fruit and veggies.

3) I'm not one for over-sanitizing, but when everyone else in your house is sick, I'd suggest disinfecting door handles, light switches and faucet handles as these are the easiest to get re-infected.

4) Vitamin C: 1000mg of vitamin C per day is great for your immune system and for your adrenal glands (the ones that deal with stress and secrete a bunch of your hormones). Once you're sick this might not do as much for you, but it's great for prevention!

5) Echinacea and other immune system-modulating botanicals: Talk to your naturopath about a botanical formula that can help your immune system. Certain antiviral herbs and adaptogens (botanicals that support a healthy stress response) can help the functioning of your immune system, boost its response to pathogens and also work on reducing your chances of getting sick. But keep in mind that everyone is different. What gets recommended to you might not be recommended for your bestie or neighbour.

6) FLUIDS! Drink lots of water (about 2L for the average person). Especially if you're feeling a sore throat coming on; drinking water helps to keep things moving down and out of your system.

7) Avoid sugar. A dose of sugar can depress your immune system for up to 6 hours after ingestion.

8) Stress management. Keeping your cool puts less stress on your body and its defences. You might feel fine during periods of high stress, but as soon as you relax again, your immune system also takes a breather and this is often when we get sick. For all the students out there I call it "post-exam period illness".
- work on breathing exercises, go for a walk in nature, journal, practice yoga, sing in the car (or the shower), draw or colour something!

9) Get enough sleep! If you're not getting enough sleep during the week, make it up on weekends. Sleep deficit exists! Rest and recharge your body.

10) Improve your gut health. Eating a diet rich in vegetables, and low in sugars can provide key antioxidants and nutrients to help your body run efficiently. Your naturopath may also recommend certain probiotic strains to assist your gut and immune health.

Tuesday, February 16, 2016

How to have your best and easiest bowel movement

Most of us can agree that there is something awesome about having a really great bowel movement. Yes, we as naturopathic doctors love talking about and analyzing bowel movements. We get so much information on how the body and digestive system are working, simply by looking at poop.

So today I'm telling you that you can have an awesome bowel movement and it simply involves changing your body mechanics. We can't change our toilets; they're situated at a fixed height. What I'm teaching you today is how to change your body position for the best and easiest bowel movement.

What's this big secret? Well, not a secret at all. Our bodies were designed for it, but we simply stopped practicing it: The full squat.

The squat is an amazing position that our bodies were designed to do. I don't think I realized how big of a difference it would make until I did a little back-country camping on unofficial camping sites - meaning, no thunder boxes. You had no choice but to take a little shovel with you and squat in the woods. I managed to find an area with a huge root of some sort coming out of the ground, much like the squat bars women find in hospital delivery rooms for birthing. In this position, you are giving your body the most favourable position for elimination.

Sitting with your knees at a 90-degree angle can actually work against you by "pinching" off or restricting passage through a section of the colon. It's another reason why the squat position is favourable for birthing; you're creating the most favourable position (smooth muscles, ligaments,  general pelvic floor) for elimination.

From: Squattypotty.com


How do you do it? 
Easy: Take a step stool (like the Rubbermaid ones we all have in our homes) and place it in front of your toilet. Alternatively, you can purchase a Squatty Potty that has a slightly better design. Step up on the stool and using support as necessary (some of us are not used to squatting that deeply), lower your pelvis (sans pants) to the toilet. Knees should be nice and bent and you should feel a lessening of pressure in your pelvis (this is part of the magic).

What will you notice?

1) Less straining. That poop will leave your body without a fight. Just a smooth train out of your body and into the bowl.

2) This also means less chance of getting hemorrhoids, less chance of fissures and of bleeding.

3) You will likely poop faster because there is less resistance.

4) You should feel like your bowels have been evacuated. Sometimes we feel like we just didn't get everything out. Well, this will decrease that likelihood.

This form of elimination is also quite helpful for people who suffer from constipation and hemorrhoids, as you're decreasing the internal pressure from fecal matter. Try it out. You have nothing to lose, other than poop, just be mindful of your body and make sure that you're lowering and lifting your body on the stool safely. No one wants to get injured while on the toilet.
Happy pooping!

Tuesday, January 26, 2016

Stepping into your "Right-Brain"

I recently re-watched Jill Bolte Taylor's TED talk. She's a neurology researcher who suffered a stroke and relives the experience for her audience, describing the sensations and thoughts she encountered at the time. I'm in tears every time I reach the end of her talk. Not just because she went through something so terrifying, but because of the message she leaves you with.

Having done a decade of post-secondary education, I'm what my family considered a "permanent student". Even now, I continue to research, to learn, to catalogue information. I use the left-side of my brain most often; calculating and analyzing journal articles and new research.

Jill, a fellow scientist, brought up an interesting point: We all have a choice of which reality we want to live in at any given moment; You can live in the analytical "Left side" - which is great while at work or when trying to figure out something, but you can also step into the "Right Side" of the brain and be connected to the world at any given moment.

What is the "right side" of the brain? 
It's the "creativity" side. Working puzzles, learning a new skill, exploring your imagination, writing, dancing, painting, drawing, colouring.

Why is this important? I think we need to access that side more often in our world. I was listening to an old podcast of comedian Bryan Callen where he mentioned the incredible fact that he gets paid to use his imagination. How many of us can say that? So why not?

Do something each day to access that side of your brain. Maybe that's another reason why adult colouring books are so popular. We now have another way of using the right-side of our brains. For adults, this isn't always easy. We have responsibilities, work, bills to pay. But life isn't just about working to make money, to pay bills and save up for retirement. It's about experiencing the world around us. Don't ever forget to connect with nature, connect with creativity - no matter what that means for you. You might think you're terrible at drawing. Maybe you actually hate colouring, but there is always another activity that you can do. Remember that this is just for you. No one will judge you. And make sure to do something that you enjoy.

Maybe that's what stops many of us from exploring our creativity: the fear of being judged. I have an entire folder on my computer of stories and novels that I've started and most I've never finished. Sometimes a girl just has to write out a chapter or two to get it off her chest. I don't expect anyone else to read it. Once every year I'll go back to it, and I can remember what it was like writing it. I take a little pride in it. And then I'll go start something new.

Things to keep in mind:

  • No one needs to see it but you. Keep a portfolio, sketches of something, or nothing. Pick up some paint and a canvas from the dollar store and just fill the space. Make a mess, or put it up on your wall. It doesn't matter. You're doing it for you, no one else. 
  • Dance when no one is watching. Swing your arms wildly, spin in circles - just try not to run into furniture! Or download Carmen Electra's striptease aerobics, Zumba or any other video that will teach you choreography step-by-step.
  • Sing when no one is listening. My favourite is in the bathtub... you get the best acoustics. 
  • Journalling and diary keeping doesn't have to be like it was in grade school. Make lists. maybe they're to-do lists, or "favourite" lists, or something more creative. Need some inspiration? Check out the List App (one of BJ Novac's projects) - other examples:
    • best books that made me laugh out loud
    • Most bad-ass movie quotes
    • Things I say to myself out loud when I'm alone
    • Favourite nostalgic moments from the 90's
    • best "pump you up" music videos 
    • Most impressive or surprising sports moments of the week (apparently the Bronco's had a crazy game last weekend... so document it!)
The point is, we all need time to disconnect from our "analytical" sides and step into our "right-brain" at some point. It keeps us going and nurtures the soul. Use your imagination - it might surprise you :)



Friday, January 22, 2016

How haters are incorrectly using almond milk

New stories keep creeping up and everyone seems to love bashing almond milk and other nut-based beverages. So what's the deal? Why all the haters?

There's a huge misunderstanding in the public's nutritional education. We grew up being told that milk "does a body good". We were told to wean our babies off of breastmilk and onto cow milk, and that dairy is required for calcium for our bones. Well, we know they weren't exactly correct about this one. But this isn't a "dairy-bashing" blog either.

What is (any) milk good for? Remember, we grew up putting milk in our cereal. It was a rule in my house to "drink milk with your meals", and a "double-double" at Timmy's trained me to always drink my coffee with milk it in. But since my early 20's I've been lactose-intolerant. Out goes all my dairy, and now what's a girl to think?

With enough vitamin D, weight-bearing exercise and a healthy diet (lots of veggies for vitamin and mineral support), my bones will be just fine. But it always helps to have beverages that are fortified with extra calcium and vitamin D just in case we don't meet our quotas for the day.

Almond milk isn't a "health food" necessarily. It's a substitute for those of us who want something with that "creamy/milky"-type of consistency and flavour. I drink my coffee black now, but every once in a while whisking in a little coconut milk makes for a nice creamy treat. And almond milk? It's a nice alternative to plain water (or cow milk) for making my smoothies and post-workout shakes.

What almond milk is not:
1) A good source of protein:
Seriously, to make almond milk you soak the almonds, drain them, combine with water in a blender, strain them and press out the "milk" from the almond paste and that's about it. I read a crazy article in which the company Almond Breeze was being sued for how few almonds were in their almond milk. Well... duh. What did you think you were drinking? It's not a liquid trail-mix.

2) A substitute for breastmilk or any infant formula.
I hope this is common sense, but according to an article on IFLS a doctor in Spain told their patient to use almond milk as a formula. This parent had never breastfed their infant and instead had given her baby cow's milk for the first 2.5 months. The problem here is a lack in education for new mothers. This story also came out of Spain so I can't comment on the availability of education for new parents as I really don't know. Either way, the whole thing is ridiculous - IFLS commented "... this latest report highlights the need for parents to take into consideration the nutritional content when choosing a diet for their infants", but seriously? Choosing a diet for your infant: Breastmilk or formula (breast is best, but there are some circumstances that may prevent this). At 6-8 months, or when your kid hints that they're ready, you can slowly introduce solid foods in the form of mashed up veggies (baby food). What isn't an option is choosing a "milk-substitute" as an infant formula. And most companies will actually print on the carton "NOT TO BE USED AS A SUBSTITUTE FOR INFANT FORMULA".

Almond milk isn't the bad-guy here, and sorry IFLS (I really do effing love science!), but it also doesn't cause scurvy as your article title implies.  It's a lack of education and really bad advice from a doctor.

What almond milk is:
1) A substitute for milk for those who can't drink it but like to use it in stuff like: coffee, tea, granola/cereal, baking, smoothies/shakes.

Haters, please don't hate on the almond milk. You're just not using it correctly. Please leave it for us lactose-intolerants (or dairy-sensitives) who just want something creamier than water in our smoothies and a splash of something white in our coffee.