Just as optimal integration of lab results into our patient work-ups makes ‘the invisible visible’ we thought we might make visible some of the everyday Q & A that we engage in with wonderful practitioners who are fast becoming Diagnostic Divas & Divos.
Practitioner: I am currently doing the MasterCourse I & loving it! I just want to clarify time-frames for change with respect to high liver enzymes e.g. male client has made awesome diet changes & lost about 10kg over 12 weeks but I’m slightly disappointed some of his markers are still high. You’ve said that most liver enzymes have a half-life between 2-10 days so, I guess it just takes more time to repair any damage/reduce fatty filtration of liver and ALT reducing by 10 is great and with the weight off and healthy eating it will continue to decrease?
Rachel: This is a great question you ask and one worth clarifying:
So the half-life of the LFTs is most meaningful with respect to a transient effect or artefact – raised GGT with drinking EtoH or raised AST/ ALT post strenuous exercise – this aids us in recognising the ‘window’ to allow for normalisation following a time-specific event/action or interference
But when raised levels reflect chronic change/pathology/or a pathophysiological process, at the very least – of course, it is no longer about how long that enzyme remains in the b/stream but about the time it takes to turn this unhealthy state of the liver around. I know you know this because you basically answered your own question🤓💪 I would say you are making GREAT progress with this patient not only by the reduction in ALT (and corresponding increase in De Ritis ratio) but also by the impressive drop in triglycerides and GGT!
The primary objective of MasterCourse I is to realise the true value we can extract from the most commonly performed labs (ELFTs, FBE, WCC, Lipids & Glucose) which constitute the largest biochemical dataset we have on almost every patient. By learning how to comprehensively interpret these labs in an integrated medical framework, using the very latest science, we can extract the gold often buried in this goldmine. Accordingly, we prove ourselves to be the greatest asset to our patients, to other health professionals we are sharing care of patients with and we cut the cost of additional expensive testing, that is less well understood and validated.
MasterCourse I will help you access that gold and has been intentionally designed to match each lesson with real learning– with the time spent in theory and in application. Delivered across 24+ hrs of streaming video sessions with bonus pre-sessions, audios, resources and tools – this MasterCourse is likely to be a genuine game-changer for the way you practise and the potency of your patient prescriptions.
6 sessions of online learning video presentations (total 24+hours)
Rachel provides you with questions, mini-assessments & lots of opportunities for case study application, testing your comprehension & understanding as you go.
Included BONUS preparatory videos: Patient Pathology Manager + Accurate Pathology Interpretation Starts Here!
Included BONUS audios, notes, desktop resources and templates you can use in your clinic with your own patients.
You get to keep all content in your online account forever and replay as often as you like.
I became interested in working in mental health not entirely of my own free will. I guess you could say, it had made it’s way into my world via family members and friends as well as my own problems when I was younger. So when I was at uni and I came across any information about mental illness, whether it was pathology or prescription, it was when I undoubtedly resonated most strongly with what I was learning. I’ve had some great opportunities throughout my career to feed my interest, met some wonderful mentors and some other powerful teachers who were often my patients. It’s now become a running joke among my teenage children that all my friends are either psychologists or have some sort of mental health diagnosis, ‘…and what does that say about you?’ they love to add teasingly. Well it says a lot probably: that I enjoy people who are comfortable talking about the psychology of our lives and ourselves, that I deeply appreciate that to be human is to suffer and we all suffer it’s just a question of degrees and the bravest of us share that with others. Lastly, I think it tells you that I live in the real world with real people 🙂(more…)
I’ve received so much lovely feedback (fan mail!) recently I just had to share some with you (note I look much more excited than Meg does when I get mine!). It’s so exciting to be a part of our burgeoning naturopathic & integrative network. From Alyssa Tait a Brisbane based naturopath, clinical nutritionist & physiotherapist: “I am so appreciative of your mentoring and your professional development (e.g. recent Health Masters Live webinars). You make me really enthusiastic about being in this field, and you actually help me feel like I sort of know what I’m doing…most of the time!!”(more…)
I love Rachel! She is an extraordinary clinician and researcher and still manages to maintain a sense of humour despite the volumes of work she does and the number of other practitioners and students she supports in addition to her own research and teaching.
Rachel is superb at honing in on critical issues that are not always immediately apparent. One of her greatest strengths is her ability to examine a case in-depth and break it down piece by piece to determine what tests might be most valuable, and then to interpret the lab findings in an overall context, e.g. what a patient’s copper balance is in relation to zinc, rather than just looking at independent values, in order to build a comprehensive picture of a patient’s health or otherwise.
Rachel invariably pulls a rabbit out of the hat … ! Not only is she supremely generous with her knowledge and clinical expertise, she is always glad to share her research and has been known to go to extraordinary lengths to set aside time for supervision / mentoring – even if this means 9pm on a Saturday night!
“Sessions with Rachel have given me the insight and knowledge I need when I don’t have time to research myself. An hour with Rachel is similar to three months of filtering through books and data. Valuable evidence based knowledge and support for any practitioner”.
“I have found the mentoring sessions with Rachel invaluable in terms of professional development and support. Typically the clients that come through the door present with quite complex health issues. This can be overwhelming as a new practitioner, and having Rachel to discuss cases with has been a huge boost to my confidence and my effectiveness.”
Cate Creemers, Naturopath & Medical Herbalist
Ibod, Clevedon, Auckland
