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There are many different potential sources of satisfaction that come from working in integrative health.  The first that comes to most of our minds of course is the deep satisfaction that comes with solving a complex health riddle for someone and knowing that you have helped to change their health trajectory – sometimes for ever.  That’s an extraordinary role we can play.  I carry many of these patients’ stories with me, very close to my heart, they give me hope and encouragement and light in the dark.

I know this isn’t the only thing that triggers a sense of achievement though.  Sometimes there is deep gratificaton in strange places.  

Like when a patient comes to see you & you tell them they’re in the wrong place. (more…)

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I keep hearing the name, ‘Molly’: “I think I’ll use ‘Molly’ for this patient” or “A bit of ‘Molly’ might go well with the zinc for their high copper”... a moment of confusion on my behalf, (Molly who?) and then the slightly late…’ooooooooh Molybdenum’. Gotta love a trace mineral that is having it’s heyday…right?…right?

There are often jokes made about how little time medical degrees dedicate to teaching nutrition in general – was it 1 lecture or 3? – but let’s be honest, who among any of us really knows the ins and outs of this transition metal.  I reckon we spent maybe 15 mins in my undergraduate on it and that was BC (Before Computers!) so I am guessing that 15mins has expanded about a gooooooogle times and we’ve come to a more comprehensive perspective.  What do we need to update on? (more…)

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Recently, I posted about my very positive experience of the AIMA NZ conference, prior to that I was gabbing on about the upcoming ACNEM Brain Health conference in Melbourne in May and now I am going for the conference hat trick!  I want to revisit a really impacting lecture for me at last year’s Australasian Society of Lifestyle Medicine (ASLM) conference, delivered by the Emeritus Professor Mark L. Wahlqvist AO, BMedSc, MBBS, MD (Adelaide), MD (Uppsala), on the relationship between ecology and human health.

Why did I find his talk so impacting?  Why should every integrative practitioner take the time to watch this? (more…)

integration

Just back from a truly wonderful Australasian Integrative Medical Association (AIMA) conference in NZ.  I don’t know what it is about the land of the long white cloud but they seem to produce some of the loveliest, most earnest health practitioners and this conference reflects this, setting itself apart each year as a result of its very organic mix of speakers (general practitioners, naturopaths, nurses, specialists) who are all equally embraced and lauded. To boot we had medical students invited to attend this year and guess what, these 20 or so med students…they stayed for the full weekend much to everyone’s surprise(!), loved it and want more. Really.  At the AIMA NZ conference, on the two occasions I have spoken, I feel a sense of coming home…no I don’t mean I am about to move there (too cold!!) but I mean coming home to integrative medicine. (more…)

1980s

Duck duck GOOSE! Do you know this game?  That’s how I’m feeling with oestrogen – high-high-high-LOW!-of late. Likely similar to your experience, the majority of my female clients battle with oestrogen dominance, therefore I get so used to looking for it, expecting it: the high Cu, the profoundly elevated SHBG, maybe a raised ESR.  So much so that sometimes the low ones can catch you out, especially of course when it happens in women way way before menopause.

We’re so resolved to hear bad press about oestrogen and to be armed ready to saturate our patients with broccoli extracts of the highest order – do we remember the clinical features and markers of an oestrogen deficit and know what to do with those women who simply don’t have enough? (more…)

pigGot any patients on Natural Thyroid Extracts (NTE)?  Me too…and I am finding it’s on the increase.  What’s the deal?  What do we need to understand about this form of thyroid replacement therapy to best monitor and manage those patients already on it or contemplating taking it? Does it really offer advantages to all hypothyroid patients or just to a subset of those and how would we recognise these people who might benefit the most?

NTE are marketed as being superior to synthetic thyroxine primarily based on the fact that they provide the patient with some T3 as well as T4 and in addition to that, being extracts of pig thyroid glands, there are other thyroid and iodine based actives e.g. mono and diiodotyrosine, present in the extracts.  So in essence this is giving us more iodine and more of the other ingredients we need to make our own thyroid hormones.  Based on this, many proponents of NTE say this is a major advantage over synthetic thyroxine replacement because it is more ‘holistic’ and it supports the patient’s gland in its own hormonogenesis.   (more…)

Welcoming a new member

I just want to scream with joy…and then keep on screaming with utter frustration!  Last week I presented the culmination of months of work looking into the extraordinary manifold relationships between thyroid health, fertility, pregnancy & post-partum health for mum and bub.

The findings are breathtaking: whether it’s about being able to put thyroid Abs firmly on the ‘Must Screen’ list for preconception care, given their ability to double-quadruple the rate of early miscarriage or their propensity for triggering post-partum thyroiditis in 50% of women who possess them or being able to state emphatically that maternal low iodine (prior to conception as well as during pregnancy) remains the number one risk for the thyroid’s healthy transition to pregnancy.  The evidence is overwhelming that we need to pay very close attention to the thyroid. (more…)

Weed lovers

I know you’re out there. Reading a recent news article I had instant flashbacks of being a young, big-eyed, rosy cheeked naturopathic student of 20+years ago.  While my career since may have taken me in somewhat of a different direction, I know many of my colleagues have stayed true to their roots (both weedy and herbal) and love nothing more than a bit of urban foraging.  Sometimes even sharing their bounty with me, much to my delight.  I salute you! (more…)

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This week I must have spent more than my daily time allocation (5mins) on Facebook and as a result I stumbled across an article I actually read from beginning to finish!  The title called to me, “Bad Parent, Hey Bad Parent”…it works every time right?  Anyway, once I started reading it I thought, no this is useful, we all need that manual that everybody talks about but nobody seems to own and I know this relates to not only the way I am bringing up my teens but I can pass on its pearls to my patients who are parents of teens as well.

My kids have been teens mathematically speaking for 3.5 years now, but I’m pretty certain, the metamorphosis happened just last Tuesday for one and a couple of months prior for the other. (more…)

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I’ve managed to befriend a microbiologist.  I know it wouldn’t excite everyone, but it’s my big good news story of the month and I can’t wipe the smile off my face when I announce this to friends and colleagues. Friends don’t get it. Yet another Rachel weirdism. But colleagues…every single praccie I’ve told says, “Oh wow!!!! Where can I get one of those??!!”

What’s even more special, is that my new BFF is not just any pathology lab scientist – she’s a passionate one, describing herself as, ‘the only one in the lab who would get excited about things, write down ideas and thoughts about how this patient might be presenting and remember to chase up doctors notes to see if I’d come close!’ 

I know…I’ve met my match 🙂 …we could talk for days without drawing breath! And wouldn’t you know it, the more I learn, the more questions I have, which is always a good sign. (more…)

digging deeper

Have you still got some thyroid patients that don’t fit any sort of traditional thyroid disease model and are difficult to get results with? Oh yes me too… and watch out…I’ve been spending the last few weeks with my nose firmly embedded in hundreds of articles digging around for more answers. As I am presenting on thyroid conditions for ACNEM in Adelaide March 18-19th, I couldn’t resist going back to the literature to see if by delving a little deeper again I could come up with some more answers to these weird, wacky and hard to treat thyroid presentations that we’re increasingly seeing and guess what…I think I’ve found a few gems. (more…)

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We all try and surround ourselves with fabulous people in our workplace and I have been luckier than most.  I’ll talk more another time about how to attract the right people to work for your business but right now I just want to share a gem from the fabulous Freya who currently fills the role of my 2IC.  You see Freya is a straight talking, millenial, naturopathic graduate (Dux might I add ;)) who happens to work for the dark side as well.  Yes, it’s true, long before she started working for me, she was working for a coffee company.  Now much to Freya’s amusement this gives her a front row seat to see the foible of this addiction up close….and being a straight shooter, she thinks we humans are a bit slow 🙂 (more…)

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This year has kicked off with lots of time spent re-calibrating my own and other practitioners’ businesses models via business mentoring and it’s such a privilege.  One symptom that seems to creep into almost every practitioner’s business model though, is one of over-delivery. (Curse that empathy and all those good hearts hey!)  Over-delivering comes in many forms, it might sound or look like this…

“I always run over”

Rather than responding to this with further self-criticism and , pledging better allegiance to the clock – we could hear this as a reflection that our appointment structure is out-dated or unsuitable.  We need to restructure to allow for the time we really do spend and need to spend with our clients and then adjust the appointment fees appropriately. Having said that be aware of the other golden oldie: (more…)

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I’ve been digging around in the scientific literature all about appendicitis and I’ve ended up here.  Long gone are the days when medicine foolishly considered the appendix without purpose – a dispensable ‘extra’ of the GIT and now, thanks to genetic PCR bacterial identification, gone also is its more recent portrayal as something sinister – a potential harbourer of ‘bad bugs’. The current consensus about this apparently complex little sac is that it constitutes a ‘safe house’ for the microbiota within the GIT, making one of its key roles the healthy recolonisation of the gut following diarrhoeal episodes and even oral antibiotics.  Amazingly, antibiotics that can quickly sterilise the rest of the digestive tract, fail to clean out the appendix, due in part to its specialised and exaggerated biofilm as well as its more diverse and environmentally tough species.  Wouldn’t you know it, the strange little sac has a critical role in keeping us well?!

Given this radical rethink of the healthy appendix I wondered whether medicine’s understanding of appendicitis and in particular what causes it, had also undergone a revolution.  This condition, which was first described over 100 years ago has confounded scientists and clinicians ever since – I love this quote from a 1972 paper in the Medical Journal of Australia (Williams):

“It is interesting and humiliating that a small organ which in man performs no useful function can so frequently give rise to problems which, if not treated, may have fatal complications, and of which we
still do not fully know the cause.” (more…)

Picture3Yep, I’ve had them…and made them.  I often hear practitioners say they cringe when they think back about the patients they saw in the first year because of the vastly greater knowledge they have now.  I do too. But my mistakes are more recent than that!

 I know more this week than I did last, and that is a good thing…right?!  For me and most practitioners, there is acknowledgement that our learning is infinite, ongoing, without end.  This is a source of excitement for me, not a negative.  The light-bulb moments are deeply satisfying – those moments when I become enlightened about a mistake I’ve been making, or a misunderstanding I have had. (more…)

Copy of Doreen SchweglerNaturopath & Medical scientist

Make the most of this special offer! If you become a 12 month subscriber before the end of January (that’s tomorrow!) you receive 10% off ALL individual mentoring sessions in 2017!

And just so you know what we have in store for you as an Update in Under 30 Subscriber this month: Rachel’s kicking off the year with ‘Melatonin – Misunderstandings and Mistakes’ – an amazing clinical update about what we are getting right and wrong with Melatonin.  This podcast answers in particular, one of the most common sources of fascination & frustration for clinicians, the reasons behind the Melatonin non-responder. We’ve all encountered patients who have taken Melatonin for sleep problems and reported no benefit, or initially responded and then lost efficacy quickly, or even patients who experienced insomnia after taking. What does this tell you about your patient and what should you do to resolve this and better still, prevent it?  Now we know. (more…)

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Have you heard what everyone is saying about the “Update in Under 30 Podcasts”? But more importantly, have you heard about “Update in Under 30 Podcasts”… fullstop?! If you’ve somehow missed out on being a subscriber & receiving these monthly gems over the last few years, you MUST read on … These dynamic podcasts will help you keep abreast of the latest must-knows in integrative medicine. Focused on one key issue at a time, Rachel details all the salient points so that you don’t have to trawl through all the primary evidence yourself. In Under 30! Each podcast represents unbiased education that can contribute to your CPE points and is delivered to your inbox every month for under $13 a month… how easy is that! (more…)

Change and back to basics

Sheeeeeshkebab I squirm at the whole premise of new year’s resolutions.  If you understand a little about the process of behavioural change, you’ll appreciate that there’s no magic dust (or firework pollutants!) you are going to get sprinkled with between pre and post midnight on any one day of the year, not even NYE, that will create a ‘new you’. Therefore to set ourselves or our patients up with such an expectation just leads to another big red rubber stamped ‘FAIL’ and guess what impact that has on your next serious attempt…yes…you guessed it…it diminishes your chances of future success because it provides evidence of our inability to change.

So my message to people during this annual transition is: Don’t Change. (more…)

Want to start 2017 with some good news?  Sometimes working with patients challenged by mental health I get scared.  A well-known colleague of mine introduced me to the notion of the ‘clinician in crisis’. The practitioner who, in the face of their patient’s extraordinary pain & distress feels overcome by the need to Do Something…Anything.  Over time I have learned to spot, what we call a ‘desperation prescription’, the patient who is on 3+ psych medications all from different drug classes and still remains tragically symptomatic. It is potentially frightening stuff.  I’ve had the same experience with patients using herbs and nutrients.  The patient’s biological drivers may seem straight forward on paper, but they fail to respond as predicted.  Nobody has a 100% success rate…not me, not Ben Lynch, not Kelly Brogan…as much as their marketing machines might make you think otherwise. (more…)