The liver is our main detoxification organ
The liver is our main detoxification organ
This year, I switched up my detox a little bit. I’ve been curious to try juicing, and I bought my first juicer. I advocate a healthy and balanced lifestyle, and after 3 months in my surgery rotation I was living ANYTHING but balanced. 100 hour work-weeks and 30 hour calls left little time for self-care. We spent most of our time at the hospital, I ate mostly hospital cafeteria food, lived completely sleep deprived, and drank insane amounts of coffee. Then I abused my body a little more by running a marathon in the middle of the rotation. My stomach was angry for about 3 months, getting progressively worse as time went on, my energy levels were in my shoes, so I felt this was time for something more drastic than usual. My boyfriend has been making some big lifestyle changes on his end so was game to try with me. We set a start date for after the Christmas/New Years family festivities. We completed 2 days of full juice cleanse, day 3 we added chicken and spinach salad with olive oil/balsamic vinegar. Day 4 we added a hearty soup with chicken, rice, onion, garlic, and organic low sodium chicken broth. Day 6 we added nuts and seeds.
My overall impression:
I feel fantastic. My energy levels are stable, without the peaks and valleys that I get when I’m ‘on’ caffeine. My digestive system instantly calmed down, the bloating reduced, and the pain dissipated. I surprisingly didn’t get any ‘caffeine withdrawal headaches’. I have continued to drink green tea through the cleanse. Other than one low point in the evening of day 2, I haven’t felt hungry, or uncomfortable. I’ve been running through the cleanse without noticing any weakness or drops in my energy which I had expected. A few things I attribute to our success, one is we ate avocado’s every day blended into one of our juices (this was actually our favourite juice). Secondly on day 2 or 3 we added a breakfast shake with unsweetened almond milk, rice protein powder, half a banana, and half an avocado. I think this shake kept us full, and gave us healthy fats and protein to keep our energy levels stable while drinking the juice.
My main complaint is day 1 to day 3 where the cleanse involved mostly juice, was costing us $40/day for 2 people. At this time this isn’t really sustainable and for that reason we opted to transition to more solid foods and a traditional detox diet. I feel so good, that I think if money weren’t an issue I would continue the juice cleanse a little longer. As time went on it got easier to adhere to and my energy was surprisingly good, and my digestive system feels fantastic. However, as a student with limited funds, I think the one week was enough to re-engage my previously healthy eating habits, kicked my nasty coffee addiction, and we’ve walked away with a few favourite juices, and detoxification recipe’s that we’ll integrate into our diet.
Our bodies are subjected to numerous toxins and stressors in life. Toxins include ones we are exposed to, like the air we breath and pesticides on our foods, and some we expose ourselves to when we eat on the go and end up choosing unhealthy options like processed foods, refined carbohydrates, simple sugars, and saturated or trans fats. Then we self-medicate with toxins like alcohol, artificial sweeteners, nicotine, and the worlds favourite drug, caffeine. In general, we feed ourselves a pretty unhealthy foundation, and then lead extremely busy lives, balancing work, families, financial commitments and deadlines leaving us with raging stress hormones that need to be processed by the same detoxification system that is trying to handle the numerous toxins we are feeding ourselves. In the end we require increasing amounts of sugar, refined foods, and caffeine to maintain our energy levels, leading to further stress on our bodies, and our detoxification systems. Toxins pile up, and as a result people are fatigued, maybe depressed or anxious, suffer from headaches, backaches, digestive concerns, weight gain (or maybe weight loss) and generally not feeling optimally healthy.
The detoxification programs I usually recomend are designed to give the body a break from all these insults. First we minimize toxins, so if you have a vice, this is the time to lose it. If you are a smoker, this is a fantastic time to quit. Sugar-addict? Sugar is not detox friendly, they contribute to rising and crashing energy levels, unsatisfied hunger, weight gain, dysglycemia or pre-diabetes, and dyslipidemia or ‘high cholesterol’! The glass of wine with dinner, and the beer with the foot-ball game are also gone. Alcohol needs to be detoxified by the liver, and at this time, we’re giving the liver a break. Over-the-counter medications should go, but any essential medications, vitamins, supplements you are taking should stay! Consult your prescriber before stopping anything prescribed medications. My personal vice is coffee, its so delicious, I drink one every day, except in my surgery rotation I can easily drink three! Its a sleep deprived medical students best friend…or is it? I came off my surgery rotation with 3 months of digestive pain, bloating, tired all the time, energy up and down, and a really short fuse. Sounds like burn-out!
Pesticides is another issue, and I know going organic all the time can be an expensive issue for many people. During a cleanse we are trying to give your body a break from toxins, and pesticides is a big area of exposure. I would recommend going organic for the duration of the cleanse, and if this is not possible consider ‘the dirty dozen’ and ‘clean fifteen’. These are lists that outline the most heavily contaminated fruits/veggies and the latter are the least likely to be contaminated. These lists give you guidelines of where to start your organic purchases. You will get much more bang for your buck by buying organic from the dirty dozen list.
According to the environmental working group (EWG) the dirty dozen plus includes: apples, celery, cherry tomatoes, cucumber, grapes, hot pepper, nectarine, peaches, potatoes, spinach, strawberries, bell peppers, kale/collard greens, summer squash. The last two (kale/collard greens and summer squash) put the ‘plus’ in the dirty dozen plus list. According to the EWG these two contain toxins that are particularly damaging to the nervous system.
The Clean fifteen list: asparagus, avocado, cabbage, cantaloupe, sweet corn, eggplant, grapefruit, kiwi, mangoes, mushroom, onions, papaya, pineapple, sweet peas (frozen), sweet potatoes.
Next, we want to remove foods that are considered top allergens as these can be harder for the body to process, and by eliminating we may uncover hidden food intolerances. These foods include: sugar, milk/dairy, eggs, soy, wheat/gluten. I highly advocate these top five, however if someone is highly suspecting a food allergy/intolerance they may be more aggressive with this list and include additional items such as peanuts, nightshade family vegetables, citrus.
Finally, we are making sure to avoid anything processed or refined. We attempt to eat foods in their whole, natural form.
Supplementation may include support for liver function and bowel function, including fiber. In my opinion, the cleanse can be complete on its own, with just healthy diet, and supportive lifestyle. The addition of supplementation is optional and gives an added boost and can be done with advice from an experienced practitioner.
What do you eat? You eat whole, unrefined foods. Lean meats and fish are great sources of protein, just avoid processed meats like deli meats. Fruits and vegetables should occupy the largest part of your diet with respect to volume. And unprocessed grains like quinoa, brown rice, and wild rice are great sources of energy, complemented with legumes, nuts and seeds, avocado for additional protein and healthy fat. Hydrate well with 2 L water, add lemon if desired for liver support and flavour. Drink non-caffeinated tea’s or green/white tea as desired. This is a controversial issue, as we ideally want to remove caffeine from our diet. Green/white tea have much lower caffeine contents then coffee and black tea, and they have the added benefit of very potent anti-oxidants which supports overall health as well as detoxification. Although I acknowledge the caffeine isn’t ideal, I still think the benefits outweigh the harmful effects, and it helps people who may be giving up coffee to deal with any unwanted withdrawal effects.
What can you expect during a cleanse? The first day or so may test your will power. If you had a daily vice, and for most people that is sugar and/or caffeine, you may experience headaches or a foggy sensation. After a few days this feeling will be gone, and you should start to feel more energetic, less peaks and valleys in your mood and energy levels, any bloating or gastrointestinal distress should start to resolve, your bowel movements should start to become more regular. If you have any difficulties with regularity, try adding 1 to 2 tbsp of ground chia seeds, ground flaxseeds, or psyllium fiber, just be sure to increase your water intake along with the fiber! You may experience the pleasant side-effect of weight loss! Finally, the most important thing is that some of these healthy habits and lifestyle changes will stick. You may pick a few foods to keep buying organic, you may have kicked an unhealthy habit, or you may adopt a few of your favourite ‘detox’ recipes into your regular menu…and if we are really lucky your diet may transition to a larger proportion coming from whole, unrefined foods and you will continue feeding your body with the raw nutrients you need to lead your current busy and active lifestyle, and feel much better doing it.
I am 7 weeks into phase 2 of my medical education. With basic sciences comfortably under my belt I have embarked on my journey through clinical sciences starting with Internal Medicine, stationed at Harbor Hospital, Baltimore, MD.
One of the first things I realized about medical education is that its divided into sections. Section 1: basic sciences. Section 2: clinical sciences. Section 3: residency. Section 4: Real Life. You inevitably start at the bottom of each section, feeling completely and utterly retarded, and then slowly climb your way up through that segment and develop some sort of hero complex, feeling like you’ve just conquered the world, and then begin the next segment realizing you are at the bottom of the totem pole again. And in this moment of realization you aren’t just at the bottom because people tell you that you are…you actually suddenly realize there is a world of knowledge out there that you know nothing about. That false sense of security you built up about who you are and what you know is shattered by the amount of knowledge you instantaneously realize exists, until now you had no idea it existed, and this knowledge, you don’t have it. As a medical student, I would say most of us are driven by some sort of sick lust to possess all of this knowledge and at the moment of realization that there is knowledge you don’t possess…you become like some sort of possessed being trying to learn two years of material…yesterday.
The second thing I learnt…is that we are not all equal. Some of my friends ‘hate’ internal med…these friends are the future surgeons, ophthamologists, emergency physicians of this world, who are putting in their time on internal med, while myself, I just love it. Every day, every patient, every case, I have this kid in a candy store feeling of excitement, thrill, drive. I always thought I would be an IM doctor….but to be here, in it now, and have my hunches confirmed by that butterfly feeling I get while I work, my jump out of bed and learn all I can feeling…its Amazing.
Lesson 3, is that patient care is my thing. I thought I might like ER cuz I’m an adrenaline junky…but I like people too much. I want to get to know my patients, work with them, and help them get better. I’ve always had a ‘thing’ for the down and out. And Baltimore is a great place to work with that population. My time at Sherborne Health Centre at the Naturopathic HIV clinic taught me this about myself. I have alot of compassion for the mentally ill, the substance abusers, the street people and the alcoholics of this world. I notice when the attending’s don’t give the same attention to their heroin shooting patients as they do to their other patients and it burns something inside me. I’m not naive, I know the likelihood is that most addicts will use again, but I don’t think its our place to make this judgement. I think our job is to give them their options to quit, to mitigate their risks, and to treat any health complications that may arise, and the rest is in their hands. I won’t give them less than my best just because they may use again. In fact, I want to go that extra mile, just in case this is that moment where they are waiting for someone to extend a hand. Most likely they won’t reach back, but if each time they come into the ER, or get admitted one person take the time to extend the hand, there may be a time where they reach back and accept it. When we give up trying, that patient will be lost forever. I hope I never lose this. I hope I don’t get complacent or jaded. I hope I always stay passionate, and determined.
Lesson four. I LOVE old people…could they be any cuter?
Lesson five. I love Baltimore. I live in a beat up old house, with cockroaches, in a ghetto with gunshot holes in the windows. But I love it. I’ve made amazing friends here…my roomies, my residents, my classmates. My next stop is Miami…I should be excited. I get to go running in shorts, feel the heat and sunshine, learn about psych and peds. But, today I feel sad….like a lay in bed all evening and watch old episodes of Gray’s Anatomy kindof sad. I’m going to miss the special people I have in my life here. I know, there will be more people in Miami, and I’ll make new friends as I always do. There are some friends here, I just don’t want to replace.
Reflecting on the last two years, 2011 and 2012, any painful memories and roadblocks, have been greatly overshadowed in my mind by the amazing life changing experiences that I’ve had.
Prior to these last two years, I was six years into a successful Naturopathic career. I built an amazing business, Action Naturopathic, filled with a client base that I thoroughly enjoyed working with. The principal that when you put out certain energy, you will get it back, and you will draw what you are hoping to attract, definitely worked out for me. I put everything into building the practice I hoped to build, and I tried to embody a lifestyle that I taught my patients how to embrace, and in return I attracted a client base motivated to make change, and to achieve optimal health and well-being. While I hoped to teach them everything I knew about achieving their health and fitness goals, they taught me about myself, about life, about relationships, and about people. Over the six years I was in practice as a Naturopathic Doctor (ND), I grew not only in my clinical management skills, but in my ability to inspire change in my patients, as well as my own personal growth.
Further to the development of my clinic, in the fall of 2007 I was hired on as a part-time clinical faculty member at the Canadian College of Naturopathic Medicine (CCNM), initially as a sports medicine and pain management supervisor, but later my role grew to eclectic shifts as well. In the following four years, I never dreaded a day of work. I routinely woke up, excited for shift, excited for my students, and the patients we would see at the Robert Schadd Naturopathic Clinic. Over those four years, working in the teaching clinic was the highlight of my career.
The word doctor, comes from the latin word ‘Doctore’, meaning teacher. Doctor as teacher is a principal I used in practice when imparting knowledge on health related issues to our patients. We teach them the tools they need to obtain optimal health, while inspiring them to have the motivation to take steps to achieve it. Putting the right foods into their bodies, the foods we should avoid, stress management tips, positive thinking, adequate sleep, adequate exercise, tips for prevention and screening for chronic diseases of health and lifestyle are all part of the tools our patients need for healthy living. This teaching roll with my patients was the part of practice I enjoyed the most and I found teaching at CCNM similarly enjoyable. My patient exposure was much higher than seeing patients at my practice alone, given that the Robert Schadd Naturopathic clinic was at that time, and presumably still is, the largest, busiest Naturopathic clinic in Canada. Furthermore, teaching the interns, and helping them advance their clinical skills for the final year of Naturopathic college was very rewarding. Over the year I spent with them, I watched them grow from nervous interns on their first days, to, flourishing, competent ND’s ready to join the profession by their time of graduation. Over the year they changed from being my students, to peers entering the profession. The transformation was as amazing to witness and inspire, as was the transformation my patients made in their journeys toward optimal health while under my care.
Despite how well my career was growing, how great I felt at the end of a day of working with my amazing patients, and the aspects of my career that I loved, there was something missing for me. I think that which was missing for me the most, was also missing for a lot of my patients.
From my point of view medical care should not be a choice between prevention OR treatment. We need to prevent disease as much as possible, and then treat if and when it occurs. Nor should we have to chose between Naturopathic medicine, OR Allopathic Western medicine, but rather we should be able to chose Natural options where they are appropriate, and chose pharmaceuticals, or surgeries, where they are appropriate. This should not be a choice between ONLY one or the other, but rather a healthy balance of both when and if they are needed. I resonate much better with the term ‘complementary’ medicine, rather than ‘alternative’. Most of my patients were not seeking an alternative to the medical system in place today, but wished for a complementary balance between their physician and their Naturopathic Doctor. Some of my patients went to their medical doctor first, and then followed up with myself, while others preferred the natural option first, and then followed up with their MD when needed. And herein lies the frustration, as the Canadian system today is not set-up for meaningful co-operation between Medical Doctors and Naturopathic Doctors. While doctors visits, lab tests, and many medical interventions are funded by OHIP, Naturopathic visits, lab tests through ND’s and our interventions are all uncovered. Lab tests that are free when run by the patient’s MD, cost the patient out of pocket expense when ordered by the patient’s ND. Furthermore, if an ND wants to conduct due diligence and run diagnostic tests to assess the care of their patient before treatment, the patient has to pay out of pocket, or the ND may attempt communication with the patients MD that can be frequently met with resistance and dismissal of the ND’s attempts at co-operation and adequate patient care. This obstacle to treating the patient was very frustrating for both myself and the patient, and furthermore, the patient is not getting adequate care or management, if their health care team is not working together, understanding each other, or agreeing on aspects of care. Fortunately for ND’s, more and more MD’s are willing to cooperate with our efforts, and some patients are willing to spend the money on testing to ensure their care is adequate.
The hardest hit are patients without private health insurance, or without the means to pay for visits, supplements, or lab testing through their ND’s. Often these are the patients who could benefit most of Naturopathic Medicine.
From the side of the profession, ND’s are struggling to stay afloat. Again, there are definitely some ND’s making a meaningful living. But many others are graduating from Naturopathic College with six figures of debt, similar in scope to the debt of MD’s, without the means of adequately paying it off. Although MD’s are able to pay off student loans within a reasonable time-frame (although there are questions about the legitimacy of the immense cost of MD education, and medical school debt load), the cost of tuition for Naturopathic college and the amount ND’s are able to charge when they graduate, puts it in question whether this tuition is justified and if the college needs to reassess fee’s and ability to payback such enormous loans. Struggling to grow businesses amongst the rising cost of association fee’s, insurance regulations, and strict advertising rules, most of which are designed to protect the public, not designed to protect the profession.
At the end of the day there are definitely pro’s and con’s to any profession, and for Naturopathic Medicine for me, the pro’s and con’s are at extremes. The pro’s for me, encompass my passion for our beliefs, our way of life, the pursuit of health and happiness for ourselves, our patients, and the communities in which we live or practice. Empowering people, communities and the public to achieve optimal health and live an active lifestyle is such a passion for me. Having that passion held back by obstacles, roadblocks, and financial stress, is frustrating at best, and at worst, heart-breaking.
So I came to a cross-roads in life…..do I keep fighting the battle, trying to convince one patient at a time, one MD at a time, one aspiring ND intern at CCNM at a time? Or do I take a risk, put it all on the line, and push myself to achieve what I want.
What is it I want? On a small scale, what I want is an integrated practice. A practice where I have the knowledge and skills to use prevention and Naturopathic options sometimes, impart knowledge about health as I believe in it, and use pharmaceuticals, lab tests, and medical interventions when they are needed. To first do no harm, using all the resources available to me and my patients. But what I’ve hesitated to admit to, for fear of not making it, for fear my passion changes, or the mountain will seem insurmountable, but the truth is I want even more than that. I want to make change. I don’t want to go through life grumbling as an ND about the way things ‘should’ be, I want to put myself out there and ‘be the change I wish to see in the world’. In my opinion, getting MD’s to cooperate with ND’s in the way I see the system working, is by educating MD’s about who we are as a profession, what we do, and about our treatment options. In order for them to work cooperatively and to refer they need to understand the science, the wisdom, and the lifestyle of Naturopathic Medicine. Teaching at Medical School(s) about Naturopathic Medicine, and teaching at Naturopathic College(s) about clinical skills, and patient management are big goals I hope to achieve in future.
I feared that as time passed I would lose my Naturopathic roots. But the truth is, it may have only strengthened. Returning after two years of medical school and catching up with old ND friends has been such a highlight. Hearing about the ups and downs of practice, brainstorming business decisions, discussing probiotics, supplements and healthy living. I still walk the Naturopathic lifestyle, with healthy eating, consuming my go-to supplements (probiotics and omega-3 fatty acids). My travel first aid kit might have some new additions (namely a good supply of cipro, an antibiotic for Travellers diarrhea), but it still has my Naturopathic fav’s (St Francis Chamomile Zinc cream, melatonin, and Passiflora). When I move for school, I make sure to have a good quality multi-vitamin, an immune booster, adrenal support, and of course, my blender for the daily breakfast shake. Despite the excessive amounts of coffee consumption, the occasional glass of wine, and the rather unbalanced lifestyle of a medical student, I’m still my old Naturopathic, marathon running self. “Iron-pumpkin’ as one of my former patients fondly used to label me. And, oh ya, I’m happier than ever before, and my passion for what I see as my mission in life, has grown bigger than ever before. I think many of my patients were looking for an MD-ND relationship, and I aspire to be the physician they were looking for. It motivates me every day, it got me through tough times in basic sciences, drove me to get the best possible mark I could on USMLE Step 1, and its motivating me to do my best at the next chapter in life….clinical rotations.
Was it worth it? Naturopathic college?…Absolutely! The friendships formed and maintained, the patients treated, and the interns taught have all shaped who I am today, and who I am continuing to become.
Was it worth it? Giving up everything and going back to medical school?…The best decision of my life! I’m excited for the destination, but most importantly embracing the whole journey, seizing every opportunity, and loving every minute of life.
Lupinus weberbauerri (Sweet Pea Familly) Taulli
Tsampa estrella, Qachqa oku
AMAZING to encounter the beautiful Passiflora plant in the mountains. I used this herb often in practice for the treatment of stress, anxiety, insomnia. A wonderful gentle herb without side-effects.
Tallwish, Taulli, Tauri
Lupinus sp (Sweet Pea family)
Tristerix longebracteatus (Misteltoe family)
Estrella rigida, Waqur weta
Valeriana rigida (Valerian)
VALERIAN…I can’t believe it. I thought this tiny little plant was so gorgous, and the picture fantastic…and to realize after consulting the book that this is valerian, a fabulous anti-anxiety, anti-insomnia herb..made by day 🙂
Tsacpa, Saltaperico, Cucharillo
Oreocallis grandiflora (Family Proteaceae) Rural use – to make baskets.
Small unknown plant with gorgeous red leaves
Curicasha, Cabeza de cholo, Ovillo de espina
Matucana yanganucensis (Cactaceae)
Peperomia hartwegiana (Family Piperaceae)
Treatment of gingivitis and otitis. Tea treats lung and kidney infections.
Hypseocharis pimpinelifolius (Wood Sorrel Family)
Naw Pashta, Qomrumshi, San Paulo
Solanum Hispidum (Potato or Nightshade, Solonaceae)
Vallea stipularis (Elecocarpaceae)
Chinchi, Pinchur, Sarsillu-sarsillu, Rupaytogro
Brachyotum rostratum (Melasttomaceae)
Agalinis lanceolata (Snapdragon family)
Rirkacock, Shoqumpa weta, Aturash, Flor de muerto
Alonsoa linearis (Scrophulariaceae Family – Snapdragon)
Apparently Gentiana was here, although we didn’t see it. A powerful bitter, useful as an apperatif to promote digestive function prior to eating. This is not my photo…photo cred’s unknown.
Puya, Qara, Cuncush, Titanca
Puya raimondii (Bromeliaceae)
Shillcu, Shillcu weta, Quico, Amor seco
Bidens andicola (Asteraceae)
Eucalyptus plant, antimicrobial
Unknown pink flower with big leaves
Llegllish qora, Tarqoy, Cebolla
Werneria nubigena (Composite, Asteraceae)
Might be of the snapdragon family, or the mint family, but not open enough to tell
Helen & Kees Kolff. Flores Silvestres de la Cordillera Blanca (Wildflowers of the Cordillera Blanca), , 2005, El Instituto de Montana
We stayed at the Llanganuco Mountain lodge, an ecolodge with a bed and breakfast feel, off grid near Yungay in the Cordeillera Blanca region of Peru. We had an amazing 4 days (3 nights) up at the lodge and did two AMAZING day hikes while we were there. One was the Lake 69 trek (see my post titled Laguno 69), and the other was the trek to the Ice Falls of Huandoy described below.
I like to review my experiences just in case other travellers are reading my blog. Our experience at the Llanganuco mountain lodge was amazing. Charlie was a fantastic host, the cooking was way above expectations, and it was the first (and only) time in Peru that my food allergies were accommodated which was an extra special treat for me. But beyond that the food was so fresh, and incredibly delicious. Our lunches were made daily based on what we wanted, in eco-concious re-usable containers, and refillable water bottles. I think we were expecting an eco-lodge experience, which we definitely got, but I think what exceeded our expectations was the hospitality, the warm atmosphere, the incredible cooking, and the amazingly comfortable plush beds. The environmentally conscious atmosphere at the lodge, along with great conversations and easy access to world class hikes made this a highly recommended stop while in the Huaraz/Cordeillera Blanca region of Peru.
The day we hiked to the Ice Falls of Huandoy, the weather wasn’t the best. Rain and clouds covered the best views, but it was still an amazing hike up to the ice falls of Huandoy, the lowest ice falls in the Cordillera Blanca. The glacier has shed ice debris that falls to 4000m, allowing locals to collect and sell the ice, and provides the local community with a very pure water supply.
I needed to make sure the ice tasted clean….it did.
View of the Llanganuco Mountain Lodge
The flowers in this region of Peru were spectacular…you might see a post to follow on the variety of flowers we found.
These incredible jagged mountains surrounded us on both sides of the valley as we hiked up towards the ice falls.
Even though the ice falls were known to experience avalanches, and people have been buried…it was hard to resist the urge to stand on the glacier for a quick photo. (We stayed out of the high risk zones…not to worry).
The Heart Shape Lake seen on the Santa Cruz Trek in the Cordeillera Blanca Region of Peru.