Ballard Naturopathic Blog | Naturopathic Medicine and Massage Therapy for the Whole Family

Stone Turtle HealthNaturopathic Medicine and Massage Therapy for the Whole Family

6204B 8th Ave NW Seattle, WA 98107 Work (206) 355-4309

Stone Turtle Health Blog

Welcome to Agape Acupuncture

April 4, 2014

For the first time in over 3 years, Stone Turtle Health welcomes a new acupuncturist to our office. Manu Saxena, EANP, LAc of Agape Acupuncture will be available for appointments on Mondays, Wednesdays, Thursdays and Fridays. Hiswebsite can be found here and he can be contacted directly for appointments. Please check out his blog for more information on the world of acupuncture.

OPPOSE HB 2149

February 28, 2014
Below is my letter to the Washington State Senate Ways & Means Committee, regarding HB 2149, which guts the current medical cannabis law in favor of profit through recreational cannabis. The bill can be found here. 

Dear Senator,

My name is Dr. Katie Baker. I am a naturopathic physician, born, raised,educated and licensed in the state of WA. I serve communities in Seattle and Bellevue as a family practice doctor, but my patients come to me from all over the state. I am writing about HB 2149, which will be coming up for review in your committee on Monday. We were told it had died in the Healthcare Committee, but a loophole allowed it to move forward without a public hearing. Unfortunately, due to the late notice, I already have patients scheduled during the hearing and will be unable to attend in person. 

I understand the difficulty of differentiating between the protection of rights for medical cannabis patients and the I-502 mandates. Here are my particular concerns with, and reasons why I oppose, HB 2149:

1- Throughout the bill, the scientific term "cannabis" has been reverted back to "marijuana". This is an unnecessary switch back to a more inflammatory term. Since this bill, if part or all of it becomes law, is the basis for legal action, the proper scientific terms should be used. Anything else is specious.

2- Section 2.12.b. As the members of the committee with healthcare backgrounds who sponsored the bill know, there are currently NO objective measures of pain.Pain is, by its very nature, a subjective complaint. Internet research shows a single preliminary study from the Neurology department of the University of Boulder, using nMRI technology to map neuronal response to pain, but there have been no confirmatory studies to date and to ask all pain patients seeking cannabis authorizations to submit to nMRI, especially when many of them are living off of disability checks or are working poor, based on a single study is unconscionable.

Requiring that the severity of the pain significantly interfere with ADLs is an unnecessary phrase, given the current terminology of intractable pain and does not allow for relief for current patients who have relapsing or intermittent pain issues that are intractable; debilitating migraines would be a good example. They do not affect patients on a daily basis, but when they happen, patients can be sidelined for 1-4 days, unable to work, keep food down, or tolerate light, sounds, or smells.

Requiring referrals from principal care providers (as the recent amendment states) does not take into account the fact that some doctors do not believe in the use of medical cannabis and would deny their patients' requests for a referral. In many cases, such as with the VA or with larger medical groups, like UW Physicians, the PolyClinic, or MultiCare facilities, doctors are forbidden to write authorizations by their employers or their malpractice providers, on penalty of losing their jobs or their insurance coverage.

3- Section 2.12.g- Eliminating the panel of physicians who accept or deny petitions for new conditions as more research becomes available would put undue strain on patients and advocates in terms of time and money. The current panel is relatively conservative, in my opinion, but is surely a better way than requiring legislative amendments or disallowing new conditions.

4-My strong opposition to the sections creating a registry come in light of recent court findings in Mendocino County, Ca and in OR, where the DEA was allowed access to the cannabis registry.Other states with registries have been compromised and patient information has been unlawfully exposed. My concerns about patient privacy and HIPAA regulations have been voiced by many during the public comment period. A patient has an authorization on tamper-proof paper, etc in compliance with state law, and that should be all the "verification" that a state-licensed outlet should require. Currently, when a patient of mine goes to a dispensary, I am called to verify the authenticity of the authorization, including its expiration date (typically one year, in some instances 6 months). There are standard HIPAA procedures for releases of information to other healthcare providers in place now. If two providers are concurrently working with a patient, releases are not even required to discuss patient care. The issue lies in patients' discomfort in disclosing to some providers, not in the lack of access to available information. 

5- Section 5.2 - Limitations are too low. Severe epilepsy patients may use more than 8 ounces in a week or so. Requiring a physician to attest to being the primary care professional treating the patient- Many patients come to me as part of their healthcare team. I encourage them to tell their primary care doctor, their oncologist, their rheumatologist, or any other specialists about their cannabis authorization. At the present date, there are 3 major drug interactions indicated for cannabis (theoretical, according to Rxlist.com). While I do a medication and supplement review at each visit and discuss potential interactions with patients, many other primary care providers (PCPs) don't do this because they do not have the time or training. 

For many of these patients, they would be candidates for the higher levels of possession proposed but their primary care professionals will not write authorizations. For others, their PCP is not the one handling the opiate. chemotherapeutic or other medications, it is a specialist such as an oncologist or pain doctor. Where is the burden of proof that cannabis requires more stringent oversight than these medications?

Home growing- Many of my patients come from rural parts of the state, where patient access points are few and of poorer quality than seen in the cities. Other patients live on a severely fixed income, often times less than $1000/month. These patients typically qualify for my sliding fee scale at the $20/visit level because their income is so low. They need the ability to grow their own plants because it is cost-prohibitive for them to afford their medication through dispensaries at today's prices, not to mention the proposed increases in costs via state-run recreational outlets.By lowering the plants from 15 to 3, it is ensured that any trouble with the growing process will wipe out a patient's medication supply easily. 

6- Section 11- While I approve of the idea of a working group to create standards of care for physician guidance, particularly one that includes professionals with actual botanical medicine training (naturopathic physicians),what we currently know about cannabis is that different people react to different amounts, preparations, and strains of the plant so a standard dosing schedule would be very difficult to determine. My typical recommendation for patients in this area is to begin dosing in the evening, or when there will be no chance for them to be impaired behind the wheel, in order to find an effective dose for them, while minimizing any impact on their lives during the process.

Thank you for reading my concerns. I am happy to answer any questions by you in person, or via phone or email. I strongly believe that feedback from physicians is sorely lacking in HB 2149 and oppose its passage.

About me: I am a 4th generation Washingtonian, in the second generation to make a career in healthcare. I have family who have served in the armed forces and  those who currently serve in law enforcement. I have over 25 years' experience working with children and families, studied botanical medicine for five years as part of my naturopathic doctorate studies, and have extra training in drug-herb interactions. My volunteer activities include working with the Sea-King County Public Health Reserve Corps, the Red Cross, the Make-a-Wish Foundation, my local Rotary and Chamber of Commerce chapters, and serving on the board of the Ballard Boys & Girls Club. In short, I believe that I am fulfilling my calling to serve families in my community and to practice responsible medicine. Part of my family practice includes writing cannabis authorizations for eligible patients of all ages, in accordance with state law.

Affordable Care?

November 20, 2013

With the new year fast approaching, the Affordable Care Act is on everyone's minds. The Washington state website and the federal website have both been prone to errors and delays because of the overwhelming amount of traffic, making researching and enrolling in new plans a pain in the neck. It's also difficult to tell if your plan costs are going to be slashed because you are eligible for a premium subsidy, stay the same (as for those with employer coverage) or increase ridiculously (as some older patients are seeing). The first time I logged on, I was told that my demographic (36 year old non-smoking female) had no plans available (we are, after all, quite a rarity!). The second time, I was told that of course there was a plan for me, as a 25 year old male smoker..

With all this confusion. surrounding the ACA and the state benefits exchange, I find it helpful to enlist the aid of my healthcare broker, who previously spent time discussing my options for individual v. group coverage as a business owner as well as comparing and contrasting my plan options. Personally, I work with and highly recommend Kathy Miller of The Miller Connection in Everett. She takes the time to find out your unique situation to provide you with the best tailored advice. In the case of the healthcare exchange, she knows tips and tricks for getting the best possible quote, which takes a more nuanced approach than just filling in the blanks on the website. 

For my patients, I want to reiterate our commitment to providing affordable care. We will continue to offer cash discounts and a cap on our office visit charges for those who are eligible. As our sliding fee scales are only offered to uninsured patients, we hope to phase this out as more Washington state residents become enrolled in insurance plans. We will continue to offer payment plans to all of our patients. Our biggest news is that Stone Turtle Health is in the process of becoming a Medicaid provider with the state of Washington. This means we will be able to provide services to patients on various Medicaid-funded state health plans who were previously not offering naturopathic coverage. 

Families will continue to be able to schedule group appointments to cut down on costs, as well. Please consider bringing in your children in the months of November and December for a free 30-minute consultation to see if naturopathic medicine is a good fit for your family. 

As we move into the new era in medical reimbursement, I look forward to being able to provide care for more families in the community and to showing patients from all walks of life how affordable and sustainable naturopathic medicine really can be! Stone Turtle Health is committed to providing safe, effective, and financially-conscious care for your family!

 

Band of Brothers (and Sisters)

September 29, 2013

I'm a big fan of Kid President. This kid stands for positive change, "being awesome" and "more dance parties". His partnership with local actor Rainn Wilson, of "The Office" and Soul Pancake is a bright light in an often-cynical and sad world I think the message that they are sharing is important. I LOVE dance parties! I want to be awesome!

Last month, I did an awesome thing. Via Twitter, I thanked Anthony Shears, a local recording artist living in L.A., for a beautiful song he had written about domestic violence. He did an awesome thing- he replied. Our dialogue, such as it was, transferred from Twitter to Facebook, to phone & email. We dreamed about what we could do to REALLY make a positive change in the lives of children touched by domestic violence or in difficult home situations. Anthony spent a lot of his childhood at the Ballard Boys & Girls Club. He tells me there were some days where most of his meals came from there. The folks at the Ballard Boys & Girls Club helped keep Anthony, his brother and their friends off the streets by providing them a safe place where they could build healthy relationships and stay out of trouble. Mentors at the Club gave the boys opportunites to play sports and support to succeed in school. Anthony went on to attend Dartmouth and work in L.A. with some legendary recording artists; Norris is an Olympic athlete. They want to give back.

My own work with children spans 20 years, in various areas such as medicine, social work, teaching, and volunteering. I believe that if we support children who need it the most, we benefit ourselves through building a strong community. Another generation will be raised up with the values that we treasure. Values like integrity, honesty, a strong work ethic, creativity, and a sense of community are supported at Boys & Girls Clubs. 

Working with Anthony, Norris, and a team of amazing volunteers, we are designing the first annual "Field of Our Dreams Celebrity Softball Tournament" to benefit the Ballard & Wallingford Boys & Girls Clubs. Money raised will help to re-surface the softball field and provide scholarship funds to the 70% of children that rely on assistance to be a part of the Clubs. Scheduled for May 4 at B.F. Day Playfield, the softball game will have local celebrities and athletes and live performances. This event can't happen without volunteers- let us know if you'd like to help!

Our first step: The upcoming Ballard Boys & Girls Club Auction to begin the fundraising for the field, held October 25th at 5:30 with both silent and live auctions. More information can be found here, as well as tickets ($45, including free childcare and a salmon dinner)

Challah back girl!

August 25, 2013

Here is a nice, nourishing recipe for a nice family Sunday brunch, using local ingredients. I love locally-made Essential Baking Company breads

Essential Baking Company Challah- sliced to 1 1/2 inch thickness

2-4 local cage-free eggs

1-2 tbsp of organic cows milk or almond milk

1 tsp ground cinnamon

1/4-1/2 tsp pumpkin pie spice

1 stick of butter

Combine eggs and milk (1/2 tbsp milk to each egg). Whisk until fully combined. Add spices. Pour into flat dish or plate.

In frying pan, melt 1 tbsp of butter for each slice of bread.

Dip slices of challah in egg mixture (both sides). 

Add bread to frying pan, allow to saute in butter until toasted, then flip and toast on the other side.

Serve with syrup (I love a gift that I got- Brandy Infused Vanilla-Hickory Syrup) or jam (homemade blueberry jam is my current go-to for my jam needs). 

Dance moves

May 24, 2013

 

Music, for one reason or another, has always been an integral part of my daily life. I meet people who can have music in the background at dinner or a barbecue, but how can you focus on anything without reveling in the songs, the lyrics and melodies changing you into whoever you were, wherever you heard that song for the first time?

Odd, this, but every few months or so, I'll just cling to some music, one particular artist or one song covered by many, as I use it to process whatever is happening in my life. Last spring, I was drawn to Leonard Cohen's "Hallelujah". Life was not good. Love was not good. Love ended in brokenness.  Suffice to say, I survived and that song (although on repeat for a few, wallowing months) stopped being so personal. I was bright and shiny and life was beautiful again. Showtunes, old school R&B, anything that was sunshine and hope and the rush from dancing at home on my lunch break or after work, became preferred again.

What I've been feeling lately is spring and summer and hip-shaking solo dance parties. I've been moving through the world, walking for miles on my lunch break. The only trouble is trying to keep from dancing in the streets to the beats in my ears.  Right now, I'm grooving to "Fugees Radio" on Pandora, which I've filled with my own personal blend of 80's & 90's rap & hip-hop (memories from middle school through college) and today's new discoveries. For a few songs, I'm no longer staring 40 (well, ok, 36) in its exhausted eyes, I'm back in middle school, before the self consciousness, before any aches and pains, when we all danced in tight circles in the gym, trying to pick up new moves.

Which brings me to Macklemore & Ryan Lewis's "The Heist", only the second album I've purchased on my iPhone (the other being Johnny Cash's "Unchained", if you must get all the details of my "diverse" music tastes). There's that resonance again. I will warn you that there's cursing, so it's not something to spring on your kids without listening first. But, as an adult, I would definitely recommend you give it a listen. Listen to the words...

"My, Oh, My" makes me tear up at the loss of Dave Niehaus a few years back, remembering how I couldn't get my mom to get out of the car and come in for dinner until the M's game she'd been listening to all the way home from work was over. "Can't Hold Us" had me freak out,  dancing with a classmate in my improv class, "Thrift Shop" has its own dance routine worked out at home (with or without my vacuum cleaner),  "Victory Lap" and "Ten Thousand Hours", about the journeyman process to getting good at what you are passionate about rings true for me every day I step in my clinic, especially those times when I wonder what the heck I'm doing and when I should know enough to give up and let it crumble versus buckling down and riding out the rough spots. "Same Love" is thrilling to me now that marriage equality is a reality in our state, in so many other states and countries. How principled, how upright to stand up for this belief in equality in a genre that routinely diminishes and demonizes those who love people of the same gender, especially before it was the law to allow everyone the freedom to marry. I am so happy that all my friends, gay or straight, can choose to live the way they want to live with the partners that they love. 

But, oh, the heartbreak on "Starting Over", his follow up to "Otherside" makes me cry every time. I want to punch a hole in something when I think about addiction and the people I love that struggle with it. I hate that these are the stories that pretty much everyone has, that there's a saboteur in so many brains.. that this disease called addiction waits patiently for so many people to have a moment of weakness. The closing line is exactly what I want to hear: "If I can be an example of getting sober, then I can be an example of starting over..."

Macklemore's willingness to share his own struggles, his openness about what he's gone through and about his beliefs, and his positive attitude as reflected in his work are all inspiring to me. I became a doctor to make a difference in someone's life, to provide caring and healing for the people in my community who need it, to help build a stronger Seattle, a stronger and better world. He's made such a name for himself as an independent artist- that, too, I admire. The hard work and heartbreak, the two steps forward, one step back process of getting recognition, especially without the backing of a large corporation. If I could say anything to him, it would be "Well done. Keep making a positive change. Share your message with as many people as possible. You are a force for good. You matter and you have a chance to change so much. Keep moving. " I realize as I write this, these are the words we should say to everyone.

So, I guess this post is just a mash note to Macklemore & Ryan Lewis, but it's also for everyone I see making a choice every day to make a positive difference in the world, to reach out and connect with people around them, to stand up for the changes they want to see happen. Yeah, "The Heist" hits me. It's beautiful. You should listen to it. And you should dance.

 

Food Revolution Day 2013

May 9, 2013

You all should know by now how much I love Jamie Oliver and his Food Revolution, promoting healthy foods in schools and communities. May 17th is the date for his Second Annual Food Revolution Day, a worldwide grassroots effort to provide fun and education experiences around food to local communities. I love what he is doing for so many reasons: healthy kids are better learners, healthy families can work together to make changes in their communities, and healthy communities can provide better support for those who need it most. I strongly encourage my readers to attentd or even host a Food Revolution Day activity in their neighborhood, even if it's as simple as hosting a vegetarian potluck or barbecue for their friends and neighbors. Check out a book about food from the library and read it to your children. Reach out to the local food bank and donate or volunteer to provide more healthy food to their customers. Visit your children's school to see what their school lunch program offers. Try a healthy new dish from a cuisine you aren't familiar with. There are TONS of ways we can improve our diets and our family's lifestyle, from meatless Fridays to making sure we "eat a rainbow" every day. We have the tools within our reach to fight the epidemics of obesity, diabetes, and other chronic illnesses that are distinctly related to our lifestyles. This is one thing that we can do something about. Viva La Revolution!

 

Fakin' it!

February 26, 2013

Dr. Ted Kaptchuk of Harvard, who has his doctorate in Chinese medicine, is at the forefront of studying the placebo effect and its place in medicine. For many folks, the term "placebo effect" has a negative connotation, used to describe why many people get better with treatment, in the absence of any measurable therapeutic chemical interaction (as in homeopathy or in drug studies where the control group is given sugar pills). However, an article released in the latest Harvard Magazine discusses how doctors can use the placebo effect to positively affect patient outcomes. Whether it's a sugar pill or sham acupuncture (as in this study), who wouldn't feel some symptomatic improvement just from feeling respected and listened to by their practitioner, rather than dealing with a curt professional who dismisses your concerns abruptly or who doesn't seem to have enough time for you? There is a very interesting and, to me, exciting field of research surrounding patient-doctor interactions and the effects that they have on care outcomes and I look forward to reading more about how I can improve my patients' health by taking the time to listen and care for them. It also inspires me to ask the following questions (please post your responses below): what makes a doctor effective? Why do you return or choose another doctor?

Winter Comfort Foods- Lightened Up!

January 21, 2013

This great post on HuffPo shows you ways to lighten up those lovely, tasty, heavy winter comfort foods. 

Some other great ways to make your favorite foods healthier:

1. For breads, like banana bread or pumpkin bread, try adding apple sauce or smashed banana in place of oil.

2. Use this list for sugar substitutes in baking: zylitol, honey, agave nectar, succanat/rapadura, barley malt, brown rice syrup, corn syrup (NOT HFCS), sorghum, blackstrap molasses, stevia. For many of these, you can find conversion charts online as they don't always translate directly to an equal amount of granulated (white) sugar. With liquid sweeteners, you may need to compensate by lowering the amount of liquid or increasing the total amount of solids in a recipe.

3. To thicken soups or sauce, add cooked, pureed califlower, potato, or zucchini

4. Lots of dairy in the fridge from the holidays or parties? Add it to soups for more flavor and to minimize the amount you'll get in each serving. I did that last weekend and came up with Baked Potato Soup, Split Pea & Bacon Soup, and Broccoli Cheese Soup. While butter, bacon, heavy cream and cream cheese don't need to be in your diet on a daily basis, this is a great way to use them up if you already have them and don't want to waste money by throwing them al out. Plus, adding a small amount of fat can increase satiety, making you more full from eating less.

5. Avoid dairy (if you don't have the problem in #4) by using stocks and broths for liquids instead of milk or cream. 

6: For richness in vegetarian dishes without adding meat, use 1 tsp of miso paste instead. It contains glutamate, which triggers the "umami" tastebuds that tell us when something tastes rich or full (which usually requires meat or butter).

Dream a Little Dream

January 11, 2013

My friend and inspiration, the comedian & musician Greg Behrendt (@gregbehrendt on Twitter) has always been someone I admired. I used to skip Chemistry class as an undergrad in order to watch his stand up specials on Comedy Central (don't worry, I passed and took 2 more years of Chem). Beyond his original voice and his incredibly spot-on sense of humor which I enjoyed a great deal, he seemed very relatable. very much a guy next door finding humor in everyday life. This was in the mid 90's and I had free cable and my own room for the first time in my life. Both were exhilarating!

Fast forward a few years: Greg goes to work on the set of "Sex and the City" and co-writes a book that a few people seem to enjoy called "He's Just Not That Into You", which gets made into a movie. He goes on Oprah, gets a talk show, and slowly stops doing what he loves. He fell off my radar for awhile, what with school and starting my first job, going back to school, and starting my career as a doctor.

Then, one day, I was listening to a local podcast, The Marty Riemer Show, that was broadcasting interviews from Bumbershoot. Marty & Jodi Brothers were talking to comedians. I'm a comedy nerd. I listened every day and heard Greg, Marc Maron, Jimmy Pardo, and others, all with their own podcasts. Greg was as charming as ever and talked about a little podcast project he was working on with his best friend, Dave Anthony, called Walking The Room. A warning: this podcast is both charming and vile. Definitely not safe for work and definitely full of gems that have actually made me fall down when listening to it on my lunchtime walks. Greg enjoys a short pant, a cardigan, and designing clothes. Somewhere in there, he began taking guitar lessons from a friend, Mike Eisenstein (formerly of Letters To Cleo, on Twitter as @USAMike). They formed a band.

Because of the podcast, I eventually got the opportunity to see Greg perform live and to meet him. As awesome as it was to do that, it was even cooler to find out that he was even more excited to meet me! We've hung out together at various podcast-related events and correspond on occasion. And he is the most encouraging person I know, bar none. As busy as he is, he always takes time to support his friends who are just starting out, or trying a new side-project. He's just good people.

So, this year, he had a bit of a mid-life crisis (which means he'll have to live to 100), had some emotional ups and downs. And he hasn't been shy about getting some help for this and talking about it. In fact, in speaking about it on his podcast, he's inspired a few of my friends around the world to seek therapy as well, which has been life- changing, even life-saving, for them. 

And what came of his therapy? This dream: to take his band, The Reigning Monarchs and, over the course of this year, create a second LP, promote the album, tour the U.S. and film it all for a documentary about "old men living their dreams". Funding is all that stands in the way. For awhile. 

The band started an IndieGoGo fundraising campaign and Greg put the word out to his fans and friends. The word spread. Their goal was $10,000 to record an album. Fans, friends, and family donated, tweeted about it, posted on Facebook and Google Plus. Everyone seemed invested in making someone else's dream come true. But, very specifically, the dream of a certain someone else who has supported them each individually with words of encouragement, enthusiasm, occasionally with connections to other folks who can help, and with an honest belief in them and their dreams, an honest concern for them and their lives.

Tonight, with 8 hours left in the fundraising, they have raised almost $26,000. They will use this money to create and produce the album, hire a publicist to promote it and book their tour, pay for tour travel expenses, and begin filming the documentary. And the day ain't over yet.