Naturopathic Medicine

Practitioner Spotlight – Dr. DeAun Nelson, ND, LMT!

 

Welcome to the third installment in our Practitioner Spotlight series!

Part of the culture here at Watershed Wellness, is celebrating what makes every practitioner here unique and a necessary asset to the team. This quarter, we’re shining the spotlight on one of our naturopathic doctors, Dr. Deaun Nelson, ND, LMT. Dr. Nelson’s body-positive approach to her practice is a breath of fresh air, in a society where not everyone gets equal-opportunity healthcare due to size, gender identification, or otherwise.

Clocking in three years as part of the Watershed Wellness staff, we’d like to give you an inside look at what life is like for this Naturopathic Doctor outside of the office.

Q. What do you love most about the Pacific Northwest?

The rain and the green. I am from Dallas, TX and it is nice to be away from heat the majority of the year!! I also really love to see the mountains and trees most days and that I am less than two hours from the ocean. I would love to live next to the ocean.

Q. Favorite cuisine?

Depends on my mood really. I can almost always go for Italian or Indian.

Q. If money was no object, where would your next dream vacation be?

World tour for sure. I would take a year and travel all over, then end my travels in Fuji for some sleeping, swimming, and delicious food in one of those huts on the water.

Q. What’s your favorite neighborhood in Portland and why?

Hmm. I rather like Sellwood. It is quiet and near the river.

Q. What’s in your Netflix queue right now?

Madame Secretary. Great show if you get a chance.

Q. If you weren’t a healthcare practitioner, what would your next career choice be?

I would probably go back to theater. I miss being part of that big creative process. Or writing.

Q. Out of the five Phase Elements of Chinese Medicine (earth, air, fire, water, metal), which one do you identify with the most?

Water. I am mutable and changeable and I often underestimate my power.

Q. lt’s your day off and you have no responsibilities. How are you spending your leisure day?

Reading, painting, or knitting. If I could do any or all of these things while either on the beach, or in a nice hotel overlooking the ocean on a cloudy, but not rainy or super windy day, (paint and sand do not go well together all the time), that would be ideal.

Q. Your top five favorite movies?

The Princess Bride, The Last Unicorn, Last Holiday, The Harry Potter series, Lord of the Rings

Q. What’s your favorite season of the year?

Spring. I love the new flowers and the mild weather.

Q. Tea or coffee? Favorite teamakers or roasters?

Yes please. 🙂 I do tend toward tea though. Townsends has a lovely Vanilla black tea that I love.

Q. Read a book or listen to a podcast?

Can I choose listen to a book? 😉

Q. What was your “aha!” moment that made you realize you wanted to be a healthcare professional?

Strange story. I had been doing theater and film, then I ended up in an office job that I didn’t really want to be in. I was in my office, considering my next steps, when “massage” popped into my head. I had never had a professional massage in my life and knew nothing about it. I ignored the idea until 2 weeks later, the same thing happened. I logged on, looked up massage schools, and within a month I was in massage school. I shifted to being an ND because I found that I was being asked a lot of things that I could not answer, but wanted to answer. I also love learning, and this is definitely a way to do that!

Q. Three words that describe your personality?

Talkative/gregarious, caring, creative

Q. What’s in your music queue right now?

I have been listening to a lot of podcasts lately, less music. I generally have Indigo Girls, Melissa Ferrick, Mary Lambert, and kd lang in my queue though.

Q. What was your favorite part of medical school/trade school?

Tests!! Just kidding. I liked learning new things and then questioning a lot of those things. I also liked the chance to expand my horizons and think critically about what I was learning. I really really liked our IV class, I even was a teacher’s assistant for that.

Q. Where do you hope your practice lands in the next five years? (and/or) What’s your biggest goal and hope with what you do? </h3?

I would like to continue with my clinical practice, but my passion lies in teaching other providers how to work with patients of all sizes in unbiased and effective ways. I would also really like to write a book or two, probably fiction, but not ruling out non-fiction either.

Q. What is a health care modality that fascinates you, that you’d like to learn more about, or that you just greatly admire?

I would like to learn more about cranial-sacral therapy and I think it would be great to get back into IV therapy someday. My biggest interest right now is to learn more counseling skills, because that has become a big part of my interactions with my patients and I’d like to grow the skills I have.

5 Ways to Manage Diabetes Without Focusing on Weight Loss

 

Have you been told that you have diabetes or pre-diabetes? Did that news startle you? Scare you? Maybe you know someone who has diabetes with some uncomfortable complications and you are nervous about whether that will happen to you.

Given the standard protocols, it is likely that you have been told that weight loss is the first thing that you need to do to help control your diabetes. It is also likely that you have tried to lose weight in the past, and have been relatively unsuccessful at keeping it off over the years. This may leave you justifiably worried that you won’t be able to follow your doctor’s orders.

Guess what? You can control your diabetes without any focus on your weight!

In fact, it is more helpful  to do the proactive things I am going to talk about in this post than it is to just lose weight. Of course, it’s true that some people’s weight does change when they start doing things to help control their blood sugar. But, this is not always the case. Regardless, the point here is to take the focus of the weight as the primary factor. One last note before we start to dig into ACTION, if you are unsure what your diabetes related diagnosis means, please see my post about the basics of diabetes to get oriented. 

Here are five simple actions you can take to help manage your diabetes in a balanced way

1. Check your glucose levels regularly!

This can be a pain, literally. Most of us don’t like to poke ourselves several times a day, but doing so can give you a lot of information about your body and how you react to different foods, exercise, stress, etc. Knowing this information gives you a lot of control over your health. Ideally, particularly in the beginning, it is helpful to check your blood glucose in the morning, about an hour and/or two hours after meals (by two hours after a meal, you want to see that your glucose is going down) and before bed.

If you are a information oriented person, this will probably be easy and interested, but it is beneficial for everyone.

Ideal is not always achievable, but checking morning and evening should be bare minimum. Many of us eat similar things daily, so if you can persist for a month or so taking your glucose after meals, often you will start to see patterns around certain foods, or times of day when foods are more or less helpful for keeping your blood glucose lower and more steady.

Information is so powerful!

2. Move your body!

Movement and exercise is a very important component to blood glucose management. Exercise helps our cells become more sensitive to insulin, particularly our muscle cells. Even after we stop exercising, our cells are more able to accept glucose, thus lowering blood sugar levels.

3. Don’t fear food!

Often, an initial reaction to a diagnosis of diabetes is fear, particularly around food. Suddenly, you find yourself terrified to even look at a piece of bread or a pastry. There are a variety of things that will affect your glucose levels and food is only one of them. Eating a variety of foods, including fiber regularly, as well as fat and protein, will help your body slowly digest starches and more simple carbohydrates.

While it is important to be aware of how many carbohydrates (not including low carbohydrate vegetables) you are consuming at any given time, as they can cause peaks in glucose levels, it does not mean that you can never have another piece of cake at a birthday or enjoy some of your favorite foods. It may take some time, but finding peace with foods, and not being scared of them, will actually help your health in general and your diabetes specifically.

4. Focus on other healthy habits!

Stress, lack of sleep, dehydration, inactivity, and dieting can all affect your glucose levels. Now, none of us live in a utopia, but spending time to make sure we are getting enough sleep and water is important. Stress will always be there, but finding ways to manage it can help it not hurt your health. I mentioned how important movement is in the first point, but it is important enough to mention twice!!

Dieting is going to be the first thing that many people go to, because their doctor has told them to lose weight. Dieting, particularly calorie restrictive diets actually can cause more stress on our bodies, which can, in turn, make it more difficult to manage blood glucose levels.

I am going to repeat myself by saying that finding peace with food is incredibly healthful, and healing.

5. Take your medication!

If your doctor has prescribed a medication for you, take it as directed and follow up with your doctor regularly to determine if adjustments need to be made. Diabetic medications are often used to help maintain blood glucose, but to be effective, other behaviors need to be adapted to help them work best.

All of these things can be done regardless of size and regardless of whether or not you lose weight.

It is also important to remember that having diabetes is not your fault. Every one of our bodies have strengths, vulnerabilities, and challenges. This is a challenge for your particular body and you do have control over how you respond by taking care of your precious body. So, give yourself a hug or a pat on the back and remember that.

If you’d like a companion on your path to health, including support in managing diabetes in an realistic way, please visit my practitioner page to learn more about my practice and to schedule an appointment. I look forward to meeting you!

A balanced view on Diabetes, Part 1 – What is Diabetes?

Diabetes is a hot button issue in our society. It can be accompanied by fear, panic and almost always plenty of misunderstanding. For instance, many people are unaware that there are two types of diabetes with different causes, thus different ways of treating them. People are also sometimes misled to believe that eating any sugar or being fat is a contributing cause of diabetes – simply not true. In the next two posts, I will attempt to correct some of these misunderstandings. First…

Here is a quick primer to dispel some of the myths around diabetes.

Diabetes, officially known as diabetes mellitus, which breaks down etymologically as “sweet urine.” Fun fact, they at one time a test for diabetes included tasting someone’s urine. As a doctor, I can say I am glad we have other ways to test for diabetes in contemporary times. The name makes sense, though, since in both types of diabetes mellitus there are high levels of glucose (sugar) in the blood, which then is passed through the kidneys into the urine when it gets too high.

The reasons behind WHY there are high blood glucose levels are what help us determine which type of diabetes a person is working with.

First, some basics. Glucose is the basic form of energy that every cell in our body uses for energy, and the brain prefers to use glucose for energy above anything else, like fatty acids. Glucose is found in every type of food aside from fat and animal protein. It is a very important thing for our bodies to have. It is so important, in fact, that our body has a way to create glucose when we need it.

Our liver can store excess glucose as glycogen and when we have not eaten in a while, for example, when we are asleep, our liver releases some of the glycogen so that our glucose does not get too low. Our bodies like things to stay in certain ranges, not too high, and not too low. Now, for the pancreas, which is a very important part of the glucose regulation process.

The pancreas is an organ that is located on the left side of our abdomen toward the bottom of our rib cage.

It has cells in it, beta islet cells, that produce insulin. Insulin is a hormone that basically provides a key to the cells to let glucose in. Without the key, the glucose cannot get into the cell and the cell doesn’t have energy. If this lasts too long, the body basically starts to starve, even though there is plenty of glucose around. This is the situation in diabetes of both types.

The first type, type 1 diabetes mellitus (DM1) is caused by an autoimmune reaction to the pancreas.

Essentially, the body decides that the beta islet cells are invaders and starts to kill them off! As you can imagine, without those important cells, there is little to no insulin being made. Without the insulin, the glucose does not have a way to get into the cells and the cells start to starve. DM1 is typically diagnosed in children, but it can also be discovered in adults.

In this case, the person will find that they are hungry and thirsty all of the time. They will also find themselves urinating a lot, because their body is trying to get rid of all that extra glucose. They often start to lose significant amounts of weight. If this situation is left untreated it can cause coma and death. Fortunately, it is often caught, and adequate treatment is available. Treatment involves injecting insulin, replacing what the body is not making itself. It is a lifelong condition to manage, and can be a big challenge, but many type 1 diabetics live long, healthy lives.

The second type, type 2 diabetes mellitus (DM2), is caused by a resistance of the cells to insulin.

In this situation, the pancreas is generally working well, but when it tries to use the key to get the glucose into the cells, the lock has been changed. It takes more keys to get the right fit, so insulin and glucose levels can slowly rise over time as the body tries to compensate. It can take years, or even decades for the body to stop being able to compensate well and let glucose levels stay high. This is why the majority of people are diagnosed with DM2 as adults.

Initial treatment often includes lifestyle changes, particularly exercise to increase the body’s sensitivity to insulin.

Also, many people are instructed to lose weight, but research does not back weight loss itself as curative or helpful in the long term for type 2 diabetics. Thin people can also get DM2, and everyone can support the control blood glucose levels through behavior changes and/or medication.

Pre-diabetes is a condition that has become popular to diagnose. What it generally means is that the person’s blood glucose is higher than what is considered normal, but not in the official diabetic range. Pre-diabetes does not mean that one will automatically become diabetic. It does, however, provide an opportunity to focus on behavior changes that will support healthy glucose regulation in the body. Again, in conventional medical scenarios, people are often told to lose weight to manage the situation.

With these important (if a little dry) basics under our belt, we can move on to action! In my next post, I will talk about 5 options to help with glucose control that do not have a weight loss focus. If you’re interested in coming to talk to me about how we can work together to manage your blood glucose levels, please do not hesitate to reach out!

The Effects of Compression: Binding, Chinese Medicine, and You

acupuncture transgender

It’s a dilemma that trans-masculine people know all too well: the need to reduce the painful experience of dysphoria on the one hand, and concerns about longterm health on the other. At first, the decision is easy; we strap down our breast tissue somehow some way, whether with ace bangs, commercially-made binders or compression shirts. The internal alarm bell that goes off when we look into the mirror or down at ourselves quiets, and we finally get some relief. All seems well for weeks, maybe months.

Unavoidably though, a new problem arises: pain.

Where the pain resides exactly depends on the person and the binding method, but it will arise. Compression of our rib case, and the soft tissues beneath, can lead to a wide variety of problems. Rib pain, shortness of breath, dizziness, and even scary chest pain can all becomes staples of daily life during binding.

Let’s examine how to think about this situation using the tools & science of Chinese Medicine. In this way of thinking, the trunk of the body is divided into three compartments, or Jiao. The upper Jiao contains the lungs, heart and pericardium. The middle houses in the liver, gallbladder, stomach and spleen, while the lower is the home of the kidney, bladder and both intestines. The final organ, the Sanjiao or Triple Burner, is a network of water passages that connects all three for the purposes of transport and communication.

In addition to the organs, we also have meridians or Chanels associated with each organs, as well as larger channels that connect all twelve.

The most-often-used metaphor for this system is a watershed that runs through the deepest parts of our bodies, which then consolidates and emerges into broad rivers between the muscles and fascia, finally concluding as small streams at our surface. What a nice metaphor – and it has broad utility. This network, according to Chinese medical theory, carries information, regulates water metabolism, and ensures that homeostasis (the balance inside our body that enables health) is maintained by subtly responding to all of the weird things that happen us throughout our lives.

Given this system’s intricate levels of communication through different kinds of tissues, imagine what might happen if we took the entire thing in the upper and middle Jiao, and squeezed. Not just once, but constantly, every day, during every waking hour and sometimes sleeping hours as well. One can imagine that all sorts of processes could be negatively impacted!

Here are a few of the potential consequences, on this view:

Blood flow: blood is hugely important process that our bodies use to transport nutrients, gasses and yang (life force) from place to place, and its functions are especially associated with the heart, pericardium and liver. If blood flow is impeded, these organs can become either too full of blood (stagnation) or have their blood supply be subtly reduced (deficiency).

Symptoms can include chest pain, pain in the ribs and abdomen, anxiety and depression.

Water metabolism: The spleen, lung and kidney are all important organs that ensure the proper flow of moisture around the body. The kidney is said to seam water up into the upper Jiao, the spleen to transform and transport it from food and drink into the other organs, and the lung to accumulate moisture and then rain it back down to the rest of the body. If the lung becomes physically compressed, moisture can accumulate and build up as phlegm.

Over time, the heat of the body can cook this immobilized phlegm into a hot goo that results in chronic congestion, hot chest pain, cough and anxiety.

Qi transformation: the work of the organs is done around the body by their associated channels, through a process called Qi Hua or Qi transformation. To give one example; the stomach channel carries the hot and drying Qi of the stomach organ up the front of the body to assist with digestion, heat distribution and immune functions.

Cutting down the size of its pathway through the chest can impede its flow, resulting in stomach organ issues like reflux, nausea or vomiting. It can also have implications for our immune systems.

All of the issues that can arise from binding can be treated through acupuncture, herbs, bodywork, and targeted exercise, but their cause is the practice itself. I want to be careful here not to engage in victim-blaming. Many healthcare providers think about this issue and say “yes, my patients should certainly stop binding if it’s causing so many problems!” But that ignores the entire reason that we do it in the first place. Dysphoria is a very real health problem with severe mental health implications.

Binding is often a life-saving act of harm reduction that allows us to life our lives without the constant mental anguish that dysphoria creates.

Surveys of people who bind find that the vast majority of people are doing it while they await the ability to access a surgical solution. Until very recently, top surgery was not covered by insurance and pain from chest bindingwas only available to those who could pay out of pocket. This has begun to change in some states, but remains the case for most people. Therefore we should remember that binding is a self-preserving response to a societally-imposed scarcity of medically-necessary healthcare.

While we engage in the activism needed to change this, here are some harm reduction strategies to consider:

  • Stretch it out: engage in stretching poses that open the chest and ribs, for at least five minutes a day
  • Build strength: strengthening the muscles of the back and chest may help hold the body of your ribcage in place and protect them from the longterm effects of compression
  • Move your body: qi and blood move when we do, and exercise of any kind helps prevent stagnation. Depending on how you bind, running may not be a great plan, but walking is wonderful for both our bodies and our moods.
  • Get some acupuncture: we can reduce stagnation and pain by unblocking channels and moving qi and blood in targeted ways
  • Take some herbs: chest stagnation and digestive issue in particular respond well to Chinese herbals formulas
  • Listen to your body: only you can know what is right for you in terms of when to bind, how to move, and how to balance all of the considerations in your life.

Above all, be gentle with yourself as you navigate the complexities of trans experience. If you want support in your journey, schedule an appointment and let’s see how we can work together.

Hormonal transition and Chinese medicine

 

This week I want to turn to a topic that is rarely discussed in any medical forum, eastern or western: hormonal transition. Hormonal transition can really refer to several experiences: puberty, menopause, andropause, and health-related hormonal shifts are all normal processes that bodies go through. Puberty for transgender people is also normal; it just happens to be medically-assisted.

There are many myths and misunderstandings about this process, and Chinese medicine can help us to see our way through them and towards a more comprehensive view.

Before we dive in, a general disclaimer: hormonal transition is a process that some, but not all, transgender people go through. Efforts to withhold access to hormonal transition over the last hundred-ish years have created very bizarre gate-keeping systems around who can access this kind of care, and although this is changing there continue to be people in the world who want to hormonally transition but have not yet been able to. Being on hormones does not make someone “more” trans or more “real”; it is simply a decision that some trans people make, in consultation with their healthcare practitioners.

Almost every body contains some mixture of estrogen and testosterone.

These hormones are responsible for a wide range of processes throughout the body, but they are best know for their roles in secondary-sex characteristics such as hair texture and pattern, body composition, skin texture and muscle mass. They both move in cycles, although the testosterone cycle is not accompanied by blood, so it tends to fly under the radar.

Yin and Yang are not concepts that map perfectly onto estrogen and testosterone, but they have a history of being framed that way. Though there can be conceptual problems with a 1:1 comparison, there is some utility to using them. To do so well, though, we have to keep a few things in mind.

First, yin is not “bad” and yang is not “good”.

Yin processes are generally cooler, slower, and more physical, while yang processes are hotter, faster and more about energy. Both are equally required for life to occur. Similarly, estrogen and testosterone exist within relationship to one another in healthy human bodies, and though the mix is different from person to person, it is that relationship that creates physiological balance.

Second, yin is not “weaker” than yang, and estrogen is not “weaker” than testosterone.

There is a strong desire to map sexist notions onto these concepts and molecules, and while I understand where that comes from, it’s misleading at best. Yin is required for life; without rest and darkness we would die. Estrogen is an extraordinarily powerful hormone that influences just as many physiological processes around the body as testosterone, including libido. Estrogens have powerful regulatory effect on bone density, metabolism and protein synthesis that people don’t often know about, because these functions are often thought of as being “masculine”.

All of these misconceptions feed into the way that people understand medical hormonal transition, even for medical providers.

This is a topic too big for this essay, but it suffices to say that people who transition to estrogen-dominance are often saddled with the dumb sexist tropes that already get hung around estrogen, yin, and femininity in general. There is more medical scrutiny, more concern (trolling), and sometimes even more monitoring. Folks who transition to testosterone dominance get the shiny things that sexism awards to men, but also sometimes experience a weird form of medical negligence that assumes that men don’t need care and that minimal monitoring is fine.

It is important to frame hormonal transition correctly: it’s puberty.

Puberty is a normal process that people go through, some earlier in life and some later. Like pregnancy, itis not an illness or a disease process, but it is wise to have a medical provider around when it’s happening. Like any puberty process, it involves a massive shift in the chemical soup of the body, in myriad ways. Appetite changes, sex drive changes in both its level and quality, and the appearance of the body also shifts. What can complicate this process for trans people who did not have access to care as young people is that one hormonal process has to be shut off, and another has to begin, simultaneously.

For people who are transitioning to testosterone dominance, this means that they are going through menopause (declining estrogen levels) and masculine puberty at the same time. For those who are transitioning to estrogen dominance, there is a simultaneous andropause (decline of testosterone) and feminine puberty.

These two processes can be a bit taxing for any body on their own, and together they can sometimes be challenging.

This is where Chinese medicine comes in. Our medicine is all about the balance of yin and yang in the body, and these hormonal shifts are just another manifestation of that process. When we treat any kind of symptom, it is within the context of thinking “is this a yin symptom or a yang symptom?”. We treat menopausal symptoms quite often, usually seen as Kidney Yin deficiency and Liver blood deficiency, and similar symptoms can appear with testosterone supplementation. Andropause can cause coldness, lethargy and sadness, which we usually see as Kidney or Spleen yang deficiency, and we sometimes see similar patterns in people who are supplementing estrogen.

None of these symptoms are terrible, and they usually disappear over time, but we can get them to resolve much more quickly by treating them.

Transgender people have been informed, either explicitly or implicitly, that our healthcare is a burden  and that we should just be grateful for whatever we get, regardless of quality. The time for accepting this message is rapidly coming to an end. People can transition without any help with side effects, and we have been doing so for decades, but we don’t need to. We can have an even better and more fulfilling experience of transition with a little bit of extra help from a medicine whose entire raison d’etre is balancing yin and yang.

I’ve helped many people through this process already, and I’m excited to work with you. Please get in touch if you have questions – otherwise you can just get on my schedule.

The LGBTQ community, health outcomes & the importance of relationships in healthcare

In this moment, in this world, being a queer and/or trans person can feel really hard and scary. It can be hard to prioritize your health and well-being in a world that seems hell-bent on making your life terrible. I’ve written before about the utility that Chinese medicine has in treating anxiety, depression and chronic pain, which disproportionately effect the LGBTQ community, and today I want to talk about something a little more subtle: early detection of possible health issues.

Statistically-speaking, queer and trans people are less likely to have a serious illness or condition diagnosed early-on. (1) This results in poor treatment outcomes, especially for potentially life-threatening conditions like diabetes and cancer. The reasons for this trend are multifaceted; many queer and trans people are low-income and cannot afford preventative care, many LGBTQ people fear (often correctly) that they will be subject to harassment or cruelty in medical contexts, and healthcare providers are not always trained in how to appropriately do screening tests for bodies like ours.

There is also just the human level of things, where a provider who feels discomfort with a patient because of their perceived sex/gender/orientation will be more likely to forget questions, or will feel shy or awkward about having the conversations that need to be had. (2)

To give an easy example, let’s think about a conversation about breast/chest discomfort.

A patient who has pain in this area may feel hesitant to share this information with a provider who they do not trust, especially if they think it will result in an examination that will make them feel vulnerable or ashamed. A provider who is not comfortable with LGBTQ patients may hear the patient say “I’ve been having pain in my left breast/chest” and note it down without asking any follow-up questions, because they don’t know how to navigate the patient’s discomfort – or their own.

The solutions to this problem are easy to imagine; physicians should develop solid rapport with patients, be educated about their experiences, work through any emotional baggage that they as providers might have about certain types of patients, and pay careful attention to the patient’s comfort in the interaction. All take time, though. Often the most well-meaning and educated western medicine providers are expected to see each patient for 15-20 minutes. This can create serious problems with detailed conversation and questioning.

Luckily in the world of natural medicine, we are able to spend 40 minutes to an hour with each patient.

This means that we can get to know patients and develop trusting relationships with them over time, such that the above conversation would be more likely to happen and go smoothly. We also have specific diagnostic tools in Chinese medicine that help us to detect issues before a patient mentions them. With the patient in the above example, a practitioner might feel the patient’s pulse and notice a choppy or tense quality in the left distal pulse position (associated with the upper torso) and inquire whether the patient was having any discomfort there.

This could create an opportunity for the patient to say “oh yes, I forgot about that, but in fact I have been”. Many early warning signs of illness are subtle enough that patients genuinely forget to mention them, so having several diagnostic systems that go beyond asking questions is quite helpful. A practitioner might also look at that patient’s tongue and find discoloration or a change in texture in the part of the tongue associated with the left side of the chest, and this would have a similar diagnostic meaning, and lead to similar sorts of questions.

All of these factors, combined with a provider who has genuine competency with queer and trans people and their healthcare needs, can create a patient experience where the vital details of a patient’s symptoms are not overlooked. Working in concert with other kinds of providers, Chinese medicine practitioners can help to provide the trusting relationships that make good healthcare possible for everyone.

Resources cited

(1) http://www.familyequality.org/_asset/bg19d2/Top-Health-Issues-for-LGBT-Populations-Information–Resource-Kit.pdf

(2) http://www.sciencedirect.com/science/article/pii/S0277953613001019

Elderberry tincture, home care and staying well in the autumn from a Naturopathic perspective

depositphotos_54461861_originalAutumn is in full swing! As we start to spend more time indoors and in close proximity to each other, the chances of getting sick go up. It probably isn’t the best idea to go hang out in the cold rain to avoid the extra contact with germs, so we definitely need turn to other options that can help prevent illness!

The fact is, we are all exposed to a variety of viruses every day. Most of the time, most of us have no problem fighting off a minor viral invasion, our immune systems are incredible. The extra contact with others, rich foods, alcohol, and stress of returning to school and approaching holiday season all have a tendency to reduce our immune system’s ability to fight off illness. These are the perfect reasons to pay attention to the strength of your immune system during the fall and winter.

An easy, and tasty, way to support your immune system is Elderberry

Black Elderberry (Sambucus nigra) and Elder flower have been used historically to support the body in defending against viral illness. It actually helps strengthen the cell membranes of our bodies against viruses, preventing them from multiplying. It also increases the immune function in our bodies so that when we are exposed to viruses, our body is ready to fight them. While having a strong immune system does not mean you will never get sick, it does mean you are less likely to get sick, and more likely to have any sickness be short.

The best thing about elderberry is that it tastes great! Kids and adults alike will have no problem taking this daily during the cold and flu season. It doesn’t have any known side effects, drug interactions, and is safe for kiddos to take. *

I recommend 2 droppers-full of tincture (or glycerine tincture for kids) or a tablespoon of syrup daily during the fall and winter. The tincture or syrup is tasty to take directly, but it can be added to teas or juice. My favorite way to take elderberry is to put it in hot water with some lemon and honey. It is a delicious hot drink and a nice way to wake up on cold mornings, or calm down before going to bed. Dried elderberries can also be delicious, supportive additions to granola, yogurt, or eaten by themselves. You can get this at Watershed, or at most well stocked natural foods stores.

If you do get sick, continue to take the tincture, but increase the frequency to 2 times per day. Also remember to be sure to wash your hands frequently, drink plenty of liquids, rest, and go see your Naturopath!

A reminder for hand washing: No need to use anti-bacterial soap. Regular soap is perfect. The key is to rub your hands together for at least 30 seconds with the soap. Singing “Happy Birthday” is the right amount of time and it is an easy way for kids (and adults) to wash for the right amount of time.

*Note to pregnant women: There has been some research that indicates that the immune system of pregnant woman may overreact to the flu virus, so while elderberry is considered safe during pregnancy, ceasing it’s use if you start to get sick is a good idea to avoid increased overreaction to the flu virus. “Study: Pregnancy Causes Surprising Changes in How the Immune System Responds to the Flu.”

Stay balanced in late winter with Self Massage: Abhyanga Step by Step

At a time of year when the weather tends to keep us indoors, it’s not uncommon to feel isolated and lonely.

winterIn the darkness of Winter, many people come in requesting massage just for the sake of being touched. Examining this a little more closely, we know that touch can help to soothe anxieties, relieve stress, and of course, help with pain and tension that the body holds.

Touch is fundamental to being human.

There are a multitude of studies that show that regularly receiving touch decreases violence, increases trust, promotes stronger immunity, and helps with overall wellbeing. How does this work?

High Resolution -98Massage, and touch in general, has been shown to increase production of oxytocin and serotonin, two of four neurotransmitters that are responsible for our happiness. Serotonin flows when you feel significant or important. Oxytocin creates feelings of trust, intimacy and builds healthy relationships and is essential for creating strong bonds and improved social interactions. Oxytocin, known as the cuddle hormone, can be released with something as simple as a hug.

While it’s not quite the same as receiving touch from another person, some of these same positive benefits can also be experienced through self massage.

Abhyanga (pronounced AhbYAWNga) is a form of self-massage that is derived from Ayurveda, the Indian system of medicine. Ayurveda has always included self massage as part of its daily regimen for promoting good health.

Performed daily, it can have the positive benefits of nourishing the entire body, lubricating the joints, increasing circulation and lymph flow, and promoting better sleep. It also gives you a chance to check in with your body and can soften, smooth and brighten your skin.

Traditionally, unrefined sesame oil is used to help warm the body. In the summer, an unrefined coconut oil can be used to help with excess heat in the body as it has a more cooling effect.

Self-Massage: Abhyanga Step by Step

oilinglassWarm approximately 1/4 cup of oil using a glass jar in a vessel of warm water or a mug warmer.

Make sure the room is warm and comfortable.

Starting with your feet, take some time to rub the sesame oil into the soles of your feet.

Work your way up your legs with long strokes toward your heart, taking time around the joints with circular strokes (knees, hips, elbows).

Massage the abdomen and chest in broad, clockwise circular strokes.

On the belly, follow the path of the large intestine, moving up the right side of the stomach, across under your ribs, and down the left side in circular motions.

Finish the massage spending time on your face ears and scalp.

Let the oil sit on your skin for 5-15 minutes. This is a great time to throw on some old pajamas and cultivate your meditation practice.

Enjoy a warm bath or shower. Avoid using soap on the skin except for the more strategic areas to allow the oils to continue to nourish your skin. Try to avoid vigorously soaping and rubbing your body.

Towel dry gently, blotting away the moisture instead of rubbing your body dry.

lavenderThe use of essential oils such as lavender or vanilla has been linked with the release of endorphins, which act to alleviate anxiety and depression.

Feel free to put a drop or two into your oil to enjoy the therapeutic benefits of these essential oils during your self-massage. Please take care getting in and out of the shower or bath with oil on your feet. You may want to use a warm washcloth to wipe your feet before bathing.

“The body of one who uses oil massage regularly does not become affected much even if subjected to accidental injuries, or strenuous work. By using oil massage daily, a person is endowed with pleasant touch, trimmed body parts and becomes strong, charming and least affected by old age”

Charaka Samhita Vol. 1, V: 88-89
(One of the Great ancient texts of Ayurveda)

 

 

 

 

A Holistic Approach to Shaking the Winter Blues

Here’s another installment in our Healthbooks series discussing the late winter energy and how it affects many of us. You can read the inaugural article here, dig into nutritional approaches to late winter health, hear more perspectives on SAD and learn about how movement – especially Qigong – might help during this sometimes challenging time. For now, enjoy the new article.

CrocusI’m in love with springtime in Portland.

Already the Daphne buds are beginning to open and purple crocuses are popping up out of the wet earth. The sweet smells and the long succession of flowers emerging fills me with relief and joy. It always seems like a miracle, this annual return of beauty, after a season of bare branches, dormant gardens, and cold, damp weather!

But this time of year in Portland is confusing too!

As soon as I see and smell these early flowers I think, Spring is here! The ordeal of Winter is over! And then it continues to be grey, wet, and cold for much of the next several months. This late-winter limbo can be hard to endure.

Do you notice that you experience a significant mood change during the winter months? During an extended period of reduced natural sunlight, some people suffer from Seasonal Affective Disorder or, SAD. It is a type of depression that comes on in the winter months and lifts in the spring or summer. Mental/emotional symptoms may include sadness, anxiety, hopelessness or pessimism, feelings of guilt and worthlessness, helplessness, irritability and restlessness, and/or a loss of interest in pleasurable activities you used to enjoy. One may also experience difficulty concentrating, remembering details or making decisions and even have thoughts of death or suicide. Physical symptoms may include fatigue and decreased energy, difficulty sleeping or oversleeping, changes in appetite and changes in weight.

Clearly, with symptoms like these that have such a huge impact on a person’s quality of life and well-being, it’s important to treat SAD.

There’s a lot you can do to shake off the winter blues!

naturewalkFirst of all, take yourself by the hand and get outside to take a walk through the neighborhood or in nature, or putter in a garden. Make sure that there is movement in your life (preferably something you love to do!).

Seek more sunlight, set up a light box, and take your vitamin D. Do your best to eat and sleep well, and to reach out to others. Consider massage or acupuncture. Talk to a doctor to rule out other causes of your symptoms and to customize a treatment for you. Get to know a new herb or two.

Here, I’ll outline how I work with patients to assess cases and give an idea of what a treatment plan might include.

First, I take the time to really get to know each patient. Of course, I‘ll ask about a person’s present symptoms, their medical history and family history and what medications and supplements they are taking or have taken in the past. I’ll also want to know about a person’s diet, physical activity, sleep, relationships, life-stressors, use of alcohol or recreational drugs and the ways they practice self-care.

I’ll usually order lab tests. When a person suffers with symptoms of depression, it’s wise to rule out physiologic causes like anemia, hypothyroid, blood sugar imbalances, or vitamin D or B vitamin deficiencies. In some cases I will also rule out other hormonal imbalances. All of this information helps me to evaluate and reach an accurate diagnosis and then tailor a treatment to a specific patient. 

A comprehensive treatment plan to treat SAD would begin with dietary recommendations to optimize nutrition and keep blood sugar balanced, along with a customized exercise plan. I would also address sleep problems and provide counseling pertaining to self-care and stress reduction.

I would prescribe dietary supplements that have been proven to be supportive, including a methylated B complex, vitamin D3, omega 3 fatty acids, and probiotics. I would also do acupuncture.

Acupuncture has also been shown to be very effective in treating depression.

Results have proven as effective as Prozac and appeared weeks earlier, without the side effects of the medication.

I would discuss light therapy. Research has shown light therapy can also perform as well as Prozac for SAD. I educate patients on what kind of light box they should get, as well as advise them on the positioning of the light and timing of treatments. Also, I would offer referral to counselors or psychiatrists as needed.

Herbal medicine is one of my favorite treatments. I love to create herbal formulas customized to each patient. I have found that herbs alone can keep some people from dipping into seasonal depression, and treat SAD and depression in cases that are mild.  There are two herbs that deserve special mention in treating SAD: St. John’s Wort and Lemon Balm.

The Latin name for St. John’s Wort is Hypericum perforatum. Hypericum comes from the Greek word hyperikon which combines the two words, hyper, meaning ‘over’ and eikon, meaning ‘image or apparition’, a reference to the belief that the herb could ward off evil spirits. Interesting, isn’t it, that today it’s used to ward off our inner demons of depression and dispel the darkness of seasonal affective disorder?

St. John’s Wort has a sunny yellow flower whose common name refers to the fact that it historically blooms on or near St. John’s Day, or Summer Solstice, also known as Midsummer. It blooms at the time of year when the sun is highest and the days are longest, and it seems that it also imparts the sun’s qualities of brightness and energy to us when we ingest it as well. St. John’s Wort has been studied extensively for the treatment of depression and anxiety, and for treating SAD.

St._John's_Wort_(5976542341)It has been found to be a safe and very effective treatment for these conditions.

It has been found to positively affect the neuroendocrine system in multiple ways, increasing serotonin, norepinephrine and dopamine, as well as influencing levels of glutamate and GABA. For an adult, the recommended dose of St. John’s wort is 300mg, three times per day. As a tincture, 20-30 drops, three times per day, is recommended.

Because St. John’s wort is so effective at increasing serotonin levels in the brain, it is not a safe treatment for people who are already on SSRI (selective serotonin re-uptake inhibiting) antidepressant medications, as together they could increase a person’s serotonin to a dangerous level. This is an herb where care should be taken if a patient is on ANY prescription medication.

St. John’s wort ‘up-regulates’ a couple of liver detoxification pathways, meaning it could cause the body to break down medications too quickly and reduce their effectiveness, including reducing the effectiveness of oral contraceptives. Take extra care with sun exposure while taking St. John’s wort, as it can increase sun sensitivity and sunburn.

St. John’s wort also has anti-inflammatory, antiviral and antibacterial effects. Research has also shown it to be helpful in treating symptoms of PMS, menopause, OCD and social phobia. It also can be used topically to help eczema and minor irritations and injuries to the skin.

Melissa_officinalis_Lemon_balmThe other herb that I love to use to treat SAD is lemon balm, Melissa officinalis. The Latin Melissa means ‘bee’, and indeed, bees are delighted by the unassuming but sweet-smelling Melissa flowers when they bloom. Part of the Laminacea, or mint family, lemon balm gets its common name because of it’s lemony scent and flavor. It’s leaves are full of fragrant essential oils, which rub off on your fingers and make lemon balm tea delicious. Ancient nicknames for lemon balm are ‘heart’s delight’ and ‘the gladdening herb’.

 An old Arabian proverb says that “balm makes the heart merry and joyful”.

It is an herb that is both uplifting and soothing to the spirits, and it was traditionally used to treat ‘melancholy’. Lemon balm is gentle and safe enough for babies and children, as well as adults. Used in combination with other herbs, it’s helpful in treating anxiety and insomnia due to nervousness.

Lemon balm can boast many other health benefits, such as it’s soothing effect on digestion, and it’s antiviral abilities. One caution with taking lemon balm is that it can have a thyroid-suppressing effect if taken in very large amounts. In fact it is used in some cases where the thyroid gland is overactive.

Tea-TimeAs I mentioned before, lemon balm makes a lovely tea. The ritual of preparing a pot of tea for oneself and stopping to sit and sip a fragrant, steaming cup adds to the healing. Pinch or snip off the tops of the fresh plant and add a large handful to a teapot or mason jar, fill with boiled water, and allow to steep, covered for at least 20 minutes. If using dried loose leaf lemon balm tea, add one tablespoon of herb per cup of hot water. Traditional Medicinals also makes an organic lemon balm tea in teabags that I recommend. Drink a cup 2-3 times a day.

St. John’s wort, however, is best taken as a tincture, which is an alcohol and water extraction, or encapsulated.

Whenever you take herbal medicine it’s critical to be aware of the source and quality of the herbs. Unfortunately, the supplement industry is so poorly regulated that herbal products often contain ineffective or dangerous ingredients, and often do not actually include the herb that is listed on the label. I usually recommend Herb Pharm as a source of good quality herbal medicine. With it’s bright orange labels, it’s easy to find in health food stores. I personally know the owner, and trust the expertise and integrity of this company completely. Vitanica, Oregon’s Wild Harvest, Gaia, Mountain Rose and Urban Moonshine are other excellent sources of herbs.

If you find yourself inspired to, you can also learn to make your own medicines. Both St. John’s wort and lemon balm grow happily and like weeds in the Pacific Northwest. You’re likely to spot lemon balm growing along the sidewalk as you walk through Portland’s older neighborhoods. You’re more likely to find St. John’s wort in an abandoned lot or field. They’re both distinctive enough to easily identify once you know their distinguishing features. They’re both abundant and easy to harvest for making into medicines for yourself.

Wishing you well. Hang in there. The days are getting longer, and the flowers are starting to open. This too shall pass.