Special offer for RAN subscribers…

Not long ago, Kathryn Simpson and I were sharing a hotel room on yet another work trip to somewhere. The lights were out, it was way past our bedtime and we were just gasbagging incessantly like a couple of teens, when a thought pops into my head:

“Hey Kathryn, back when you were my student, did you ever imagine this scenario in the future – you know us being colleagues and friends and having slumber parties full of laughing?”, she replied, “Well no, but you know what I REALLY never could have imagined in my wildest dreams…the Australian Naturopathic Summit and you inviting me to be a co-founder of something that’s had such a big impact! That one I just didn’t see coming!”

Well to be honest, neither did I but sometimes I just have an idea that won’t leave me alone and is too important and too promising to ignore. Three years ago when I shared one of these, the vision of a national naturopathic conference by naturopaths for naturopaths, that would lift us all professionally, offer collaboration over competition and provide us the highest level of non-biased education, with Nirala Jacobi, turned out she’d been visited by the same thought bubble.  Then I approached Kathryn, who was working for me at the time and pretty fresh out of uni but full of passion and drive about building a better ‘new’ naturopathic career path, one that supported rather than splintered those emerging out of great courses into a harsh, challenging professional space.

Time-travel forward to now, we are just 10 weeks(ish) out from erecting the chai tent, marquees and lanterns, for the second inception of this extraordinary thing called the Australian Naturopathic Summit 24-26th August at Lennox Head.

This is the culmination of 3 years of work from us, one paid project manager and the exceptional generosity of over 25 of our naturopathic idols, thought leaders and torch bearers who are donating their time to present plenaries, workshops, case studies, panel discussions… because they believe so strongly in the cause and the need for such an event. 

If you think I am running out of breath between all these words..I am. This thing…has taken on a shape and life much greater than even we had envisioned.

If you follow the work I do – you’ll know that I am passionate about collaboration over competition.  I could never have come to this place in my career without the input of many (some who remain on speed dial even now!) and through my mentoring programs, the infamous RAN internship and hopefully times we’ve come across each other…I’ve encouraged you to do the same and by doing so, grow bigger together.  So just imagine the value of collaborating face-to-face…over 3 days…at a festival in Lennox Heads… ? And not just for 1 hour, but for 3 full days with 100’s of other practitioners from all areas, specialities and locations. Oh and if you’re thinking you’ll just have to wait ’til the next one’…SPOILER…there is no guarantee of a next one! Being a passion project that we 3 donate our time to, for you, it requires your support to keep it going.

So with saying all that…..(cajon roll…that’s a drum for you non-hippies)….It is with great excitement and enthusiasm that today I can announce a special deal for RAN subscribers. Yes….that’s you! Just like myself you all see a need to grow and build skills, knowledge, competence and confidence in the practice of naturopathic medicine. Come join the very best of your profession and take up this special offer to attend the second independent Australian Naturopathic Summit held in Lennox Head on 24-26 August.

To get 15% off a full 3 day pass enter Festival at the checkout

Book your tickets before they run out at  www.australiannaturopathicsummit.com.au.
For information or questions about this special email hello@australiannaturopathicsummit.com.au.

This summit is unprecedented in Australia for the following reasons:

  • It is free from commercial bias
  • It is about professional development, improving our practices and career paths, not products
  • The primary objective is to support the Australian Naturopathic community, celebrating our diversity and creating a platform for our own Naturopathic torch-bearers in various areas (Practice, Research, Herbal Manufacture, Corporate Health, Entrepreneurship etc.) to help light the way for the broader professional community

This year our theme for ANS 2018 is ‘Coming Together On Common Ground’
Naturopathy has many different practices and paths,
but we all work for the same purpose, guided by the same principles.

The ANS 2018 program has three distinct themes across the 3 days…

  • Friday 24 August: Custodians of the Vital Force
  • Saturday 25 August: Upskilling Your Clinical Practice
  • Sunday 26 August: The Business of Business Development

The morning of each day consists of plenary sessions followed by a lengthy lunch break that allows for networking, beach walking, guided outdoor meditation, perusing the vendor village, or simply enjoying the festival atmosphere in the beautiful outdoor location that our summit is surrounded by OR for those die-hards some amazing case studies presented by the likes of Jason Hawrelak, Dawn Whitten and Sandra Villella.  Afternoon sessions are workshop-style, designed to be more interactive. There are plenty of workshops to choose from to keep you riveted and inspired.

We have created a jam-packed program to do just that.
Download your copy of the full program here!

ANS 2018 – come join the very best of your profession.

Book your tickets before they run out at  www.australiannaturopathicsummit.com.au.
To get 15% off a full 3 day pass enter Festival at the checkout.
For information or questions about this special email hello@australiannaturopathicsummit.com.au


Enough said.

The Blame Game

Quite the month for it, I hear. My inbox has run hot with practitioners deeply concerned about some serious finger pointing that’s been going on.

The fingers in these instances have belonged to medical practitioners and the direction they’re all pointing, is seemingly at any complementary medicine their shared patient is taking.

Here’s a couple of good examples: “Your high blood pressure is the result of the combined mineral formula you’re taking!”   These were the words of a GP to a 50 something female patient when he discovered she was taking a calcium, magnesium, potassium containing formula.  The patient was hypertensive at the initial appointment, at which time the naturopath encouraged her to actually seek review, assessment and prescription of an anti-hypertensive, however the patient declined.  The nutritional prescription was recommended in response to high acidity (raised anion gap) and prematurely low GFR (impaired renal function). Patient’s HBP continued to be problematic so the next doctor she sees, points the finger and says, it must be this product!

Would anyone like to explain that to me? In fact, that was my advice back to this very concerned and understandably rattled practitioner…just to cordially request the GP to outline the mechanism by which this might occur.   (more…)

Magic Medicines?

I was just reading the results of a spot Facebook poll of GPs asking what the most wonderful medications ever invented are.  Once everyone got the customary “caffeine” gag out of the way, the rest of the nominations and auspicious award winners unfolded like a who’s who of the modern medicine prescription pad.  Naturally, Penicillin took out first prize (no surprises there unless you’ve been living under a rock…a very clean sterilised one at that that!), one vaccine made the top 10 but I thought there were a few unexpecteds in here:

1. Penicillin “Because of it, entire nations can now afford to worry more about diseases of old age rather than infection. Penicillin’s success ushered in the era of modern pharmacology. To be fair, alongside antibiotics were profound improvements in housing and sanitation.”

2. Smallpox vaccine according to the author of this poll Dr. Justin Coleman,”was a triumph of research, pharmaceuticals, human cooperation and public health planning.”

3. Contraceptive pill for changing the lives of women all around the world. True but BOY does it change it for the worse in some!! (more…)

Is Your GP Doing it Tough Right Now?

If you receive the free Medical Observer newsfeeds you’ll know what I’m talking about.  Here are some recent headlines:

I stand accused of rorting Medicare.  This is what it’s like

A GP is sued after doing everything right — except her notes 

After-hours funding shakeup

‘We’re becoming unviable,’ says GP hit with $22K e-PIP repayment

This Christmas I wish for doctors to feel valued again

So the answer is, probably.  Tales direct from the trenches that I hear from GPs, suggest it is increasingly difficult to make a living without adhering to a crazy volume of <10min appts, without being sued (too often) or dragged in front of AMA or APRHA. I hear them and know that the increased pressure is coming from multiple angles and I think it is very sad that previously such a respected and valued role in society appears to be ‘losing its value’.  Don’t get me wrong, I don’t agree with the old ‘Doctor as God’ model and think it ‘s very unhealthy actually for patients, but I feel like GPs with all their extensive training, knowledge and expertise are in urgent need of an Oprahesque ‘new dawn’!  (more…)

Two Women Over 70 Walk Into A Room…

No this is not a joke. The room they enter happens to be the clinic space of a practitioner I mentor.  The older women are friends, both originally from the UK and they sit in on one another’s consultations sharing many of the same experiences: grief over loved ones lost, memories, laughter and both describe waking in the morning with a sense of dread, because they’re tired, feel they’ve lost their oomph, their motivation, their chutzpah…that’s mostly why they’ve come today.

But know what else these two have in common?  (more…)

Working on the Edge

thin teen

May was the month of teenage girls presenting with severe digestive problems, especially ‘food intolerances’,  leading to avoidance of specific foods and at times significantly reduced food intake overall.  As integrative health practitioners,  validating and creating insight for clients on the nature and source of their food reactions is our bread and butter, right?  Is it wheat?  Dairy? Gluten? FODMAPs? Salicylates? Oxalates?  We are not surprised by how many ‘sick’ patients we see in spite of a theoretically ‘healthy diet’ – healthy for others perhaps but not  for the individual in front of you, right? But what if I told you that each of these teenage girls had a BMI < 18 kg/m2, does that change your opinion about your role?  Would you assess, monitor and manage these teenage girls differently? You should.

Take the example of one of my clients: 14yo female with a BMI 16.3, who had her first confirmed food reaction under 2yo with failure to thrive, which was attributed by a paediatrician & dietitian at the time to severe salicylate sensitivity.  She underwent jejunal biopsy at 3yo for suspected coeliac disease, due to ongoing concerns and a primary relative with CD but it was NAD.  In the 11 years since, there have been a couple of other digestive diagnoses based on solid evidence, such as mainstream stool PCR testing. So surely, the fact that she is underweight & that she skips lunch at school due to digestive discomfort is proportionate and explained by her organic digestive issues. Or is it? (more…)

Elusive Integration?

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…)

Taking Care Down There

picture1Often we assume our patients know at least the basics about health – especially about things soooo seemingly basic…that we fear mentioning them would offend and make us look like someone trying to teach grandma anything!  But there are some instances where I’ve found I have simply assumed too much.

I think the issue of what I affectionately call ‘Vag Care’, is right up there as an example.

Soapy water?  Female deodorisers, daily panty liners, re-enacting bad movie scenes with soapy suds sex…what the???  It’s been my astonishing discovery that women of all ages, but especially a frightening majority of younger females (<30 yo), in this time of increasingly unreal ideas about sex and sexuality, feel inclined or pressured to adopt these practices in order to erase all trace of natural odour and healthy discharge. The abnormal has become normalised.  (more…)

Mental Health Assessment for the Integrative Practitioner

puzzle-face-image

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…)

Anti-Epileptic Medications & Nutrient Interactions 101

meds

Ok here’s a gripe I’m having currently.  I have a number of patients who are taking anti-epileptic drugs (AEDs) and most of these are children who require them for seizure control.  Naturally, working alongside such serious pathology and these critical medications requires a conservative and evidence based approach to ensure the safety of any added intervention.  Fortunately, this is something I would like to think is one of my strengths.  When these patients present seeking nutritional support, I typically refer them for investigations that can help to clarify what, if any, nutrients are imbalanced because of their long-term AED use or perhaps because of other independent reasons that may compromise they’re overall wellbeing.  I feel that in such a vulnerable population I need to confirm nutritional deficiencies to check my assumptions, prove a need for supplementation and prevent against any excess or creation of further imbalance…and by doing so, I can adhere to my motto of least medicine, is best medicine.

The fact is AEDs are notoriously associated with a long list of potential negative nutrient interactions and the evidence to support this is extensive, this includes but is not limited to: folate, B12, B3, B6, zinc & vitamin D and the deficiencies potentially produced by the AEDs can be quite severe depending on a range of individual factors.  For many of these nutrients, the research goes further and has shown that correction of the deficiency leads to better drug efficacy – therefore adjunctive nutritional monitoring and correction would seem like a real ‘win win’ situation.

(Stargrove,MB. et al. Herb, Nutrient & Drug Interactions – Clinical Implications & Therapeutic Strategies. 2008) (more…)

What Does the new RACGP Guideline re Naturopathic Requests Mean?

medical-563427__180

It’s taken a little while for me to collect my thoughts on this one. Initially there was a little flash of anger, frustration and a good deal of huffing and puffing when I heard about the RACGP guidelines recommending GPs say no to any requests from naturopaths for further investigation of their shared patients… but I’m over that now. In an interview on 702 ABC Sydney radio last week, Stephen Eddy, the vice president of ATMS, responded to these guidelines by suggesting that a blanket directive for GPs to ignore all requests from all naturopaths about all testing didn’t really sound sensible or appropriate. Here here! Surely, in the pursuit of evidence based medicine and discerning practice decisions, each case should be considered on an individual basis.  I think Stephen Eddy gives GPs more credit for being able to make these judgements than their own association! (more…)

A Duck Called Homer? (HOMA-IR)

Duck called HomerMost of us know that measuring a fasting blood glucose to assess how well someone is managing their glucose levels is about as crude and insensitive as waiting for the smoke detector alarm to tell you your dinner is cooked!  If we wait to see an abnormal result here we’ve missed a prime opportunity for patient education and prevention long ago.  Much the same story if you’re looking at HbA1c results.

To explain this I always use the analogy of a duck.  A duck will always be able to swim but the question is how much effort does it have to exert to swim the same distance?  If your blood glucose is within range after an overnight fast that’s as good as saying, ‘this duck can swim the length of the pond’.  What it doesn’t tell you is how fast its little legs are paddling in order to achieve that.  Measuring a fasting insulin at the same time, however, tells us some additional important information.  It tells you how fast the duck’s legs are paddling just to keep its head above water!  The more insulin you’re having to secrete to just maintain normal blood glucose levels, the more alarmed we should be! (more…)

The Inclusive Specialist?

 

Lots of great conversations with practitioners following my recent post on the need to specialise – really thought provoking & clarifying ones which makes me think it’s been a good conversation starter. Key things that have come up for people are:

  • How do I choose my area of speciality…e.g. is a spin the bottle approach required?
  • Is specialisation sensible when you’re only just starting out or should you be taking everyone and anyone to begin with?
  • Is specialising even naturopathic given we have a holistic approach to health?? …e.g. I might say, I only do gut but for my IBS patients there’s a whole lot of stress management & mental health stuff that needs addressing along the way

Great questions 🙂 Now remember, all I’m offering here is my opinion, I don’t think there is a definitive answer to these but I think we should keep the conversation going as a way of keeping us thinking about the way we choose to practice rather than assuming there’s only one way to be a naturopath in clinic. (more…)

Bad Patient Days (BPDs)

I was chatting with a colleague today about a complicated & interesting case of hers, severe hypothyroidism coupled with overt hypercortisolemia (salivary cortisol up to 230!).  This is a distance patient & she’s sharing care with a couple of other health professionals with conflicting ideas…tricky!!

So when my friend received an email last week to the tune of… “things are bad, everything is terrible if not worse”, then naturally she starts worrying: What has she missed? What’s gone wrong?  What more could/should she have done? Is this some sort of aggravation to the treatment she’s recommended?

This is the place our minds naturally go when faced with these scenarios however one of the things I have really learned over years in clinic is that patients, like me, like everyone else I know, are labile, in the moment kind of creatures & we’re all vulnerable to having BPDs. (more…)

Nutritional Science & Debate in Action

 

Last weekend I attended the Science of Nutrition in Medicine Conference in Melbourne https://nutritionmedicine.org.au/enews/2015-02-06-Program.html and for those of you that didn’t make it I can tell you, it wasn’t your regular CPE event.  I’m not sure if the debate inside the presentations or outside in the breaks was more interesting but I can say that I haven’t seen this much stimulated thought, heated discussion and passion at company run events.  Why? (more…)

Top 10 Investigations in Mental Health Patients

One of the most common questions I’m asked is whether I have a ‘set list’ of tests that I request for every patient.  Of course there is no ‘one size fits all’ in health & each patient presents with their own novel combination of issues & investigative challenges, however, years of clinical experience have taught me which pathology parameters are the most clinically meaningful.

Asking yourself, ‘Will the results of this test determine my thoughts about treatment & therefore ultimately the clinical outcome for my patient?’, before referring for any investigation is a good habit to get into.

Many of us are increasingly aware of the changing environment around pathology testing, which includes reduced access to some tests in mainstream pathology.  Rbc folate has had its subsidy withdrawn which means if we request this we’re now likely to receive a serum value or nothing.  But does this matter? (more…)

Do you mind if I record our appointment?

I read an interesting news item in Medical Observer this week about the increasing number of patients either overtly or covertly recording medical appointments on their smart phones.  Have some of your patients already asked if they could do this?  Mine have and I’m also aware of some patients getting into hot water when asking their ‘old-school’ medical specialists if they could do the same thing. For me, I have always understood the patient’s desire to do this, as the information they’re being given might be complex, considered critical and they may need to hear it several times in order to grasp the details, instructions etc. In other situations I’ve experienced it’s because the patient needs someone else, who couldn’t be present at the appointment, to hear the discussion ‘firsthand’ e.g. another parent, a partner.  In my mind this all makes good sense.  Does it make me speak differently, think more carefully about my words etc…You bet it does!  (more…)

Another Piece of Naturopathic Nutritional Wisdom Goes Mainstream

Over 20 years ago (ouch!) while studying at Southern School of Natural Therapies, I heard for the first time that calcium perhaps had a ‘dark side’!  At the time, and still to a large extent now, calcium is publicly portrayed as something you simply can’t get enough of and 20yrs ago this idea was almost heresy! Certainly in the eyes of the dairy corporation at least 🙂 Yet there had been a long-standing concept in naturopathic nutrition that the distinction between calcium’s healing and harm all came down to where it resided in the body, e.g. bones Vs blood vessels.  Last week Medscape ran an editorial espousing the same concept. (more…)

End of Year CD Clearance

As we head rapidly towards the change over of our calendars we would like to offer you a special on the very best educational recordings from 2014 – buy 2 CDs before Jan 31st and receive one complimentary Premium Audio Recording of your choice  OR purchase 4 CDs and receive a 3 month Premium Audio subscription for free

It’s been a busy year during which Rachel has delivered 7 very successful new seminars in the area of mental health and  beyond, most notably fortifying her role as a leader in the field of diagnostics and pathology interpretation.  This has included collaborations with ACNEM, Biomedica, Health Masters Live, MINDD and Nutrition Care, however, each recording is classic Rachel – full of fresh perspectives on diagnosis & treatment, colourful analogies  & humour.  In case you missed some of these this year or want a copy for keeps – here’s a quick summary of the 2014 recordings included in this end of year offer: (more…)

Mental Health – The Real Story

“Two great speakers – inspirational in the first half and bang on in the second – I now know how much I don’t know”

Just out now in time for Christmas…no seriously though… this year I had the good fortune to team up with Biomedica and in particular Rachel McDonald and we delivered a 3 hour seminar called Mental Health in Holistic Practice.  The intention behind this collaboration was to shift the education focus for practitioners from a prescription based approach, to one really about the clinical reality of managing mental health clients.  Probably most of you will agree that the ‘treatment’ counts for only a portion of the positive outcomes in your patients and this is particularly true in clients challenged with mental health issues. After more than 20 years in practice working in this area, I’m keen to share what I’ve learned so other practitioners can get there much much faster! (more…)

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