Stone Turtle HealthNaturopathic Medicine and Massage Therapy for the Whole Family

While listening to Dan Savage's podcast the other night, I heard a head and neck specialist discussing the throat cancer and how an overwhelming percentage (70%!!) of them are caused by HPV, instead of tobacco use (study link here). Although vaccinations are an issue that many people feel strongly about, the HPV vaccine (which is currently being recommended for both girls AND boys) specifically focuses on HPV-16 and HPV-18, the two types of HPV that cause throat cancer, anal cancer (in both sexes) as well as vaginal and cervical cancer (in women). I've included a few links here, from the Oral Cancer Foundation and the CDC. While no one wants to think about children having sex, the window between vaccination age (beginning at 11 years old) and sexual experimentation may be, unfortunately, not that long. 

http://www.oralcancerfoundation.org/hpv/index.htm

http://www.cdc.gov/vaccines/vpd-vac/hpv/vac-faqs.htm

As young adults in our late teens and early twenties, we can be exposed to HPV through oral sex or transference from another partner who has it in their throat (from performing oral sex on their previous partner) and the oral cancer will not show up in us until our late 30's or early 40's. Given that oral sex is generally seen as a "less risky" sexual behavior when discussing HIV and pregnancy, these findings are quite concerning because they may lead people to go back to more risky, penetrative intercourse to avoid exposure to a cancer-causing virus. As always, condoms, condoms, condoms!

Happy New Year! Every January, many people make New Year's resolutions but very few of them follow through. We've all purchased gym memberships, hoping to shed a few pounds, only to see them lapse after a few visits or dedicated ourselves to a new hobby, spending money on shiny new gear only to find that same gear in the back of the closet when we do our spring cleaning a few months from now. Why do we make resolutions in the first place and why don't they stick?

I believe that we make resolutions for a few reasons- 1) peer or family pressure, and 2) eternal optimism. With the former, external pressure to make changes might be an initial motivator but won't allow us to maintain those changes. It's a stick without a carrot. The latter is just the opposite, in my opinion, the undying hope that maybe this year will be different, that we have it within ourselves to be better people, that if we only try YET AGAIN to make changes, THIS is the time they'll be successful. Neither of these are bad reasons to make resolutions or life changes, but I don't believe that they are enough to make lasting changes. 

If you change for another person, no matter what the reason, you're not fully investing yourself in that change. It's not happening because you want the end result but because you know someone who does or who won't stay if you don't change. Better to consider their request as one factor in a list of pros and cons for making the change YOU want to make. List all the positive results AND all the negative consequences AS THEY WOULD HAPPEN TO YOU. If your spouse wants you to lose weight because they're worried about your health, list all the health benefits you would attain from losing weight and all the repercussions for staying at your current weight (including the possibility of adding more) and determine for yourself if the benefits outweigh the costs. Quitting smoking? Not just because your partner wants you to, but because you will reduce the risk of cardiovascular events, breathe more easily, and be able to live a longer, healthier life with more time for your family. 

Be realistic. I always tell my patients that if they have a drinking problem, I'm not going to tell them to quit cold-turkey, but I do want them to stop drinking before noon. Then, before 4. Then every other day. We sabotage ourselves by creating unrealistic goals and then being unable to stick to them because we don't change everything in our lives to make it more convenient for us to stick with the changes. Want to drink more water? Add an extra water bottle to your daily intake or make sure you drink a full glass of water before each meal. Want to exercise more? Start with stretching for 10 minutes every morning, a 20 minute walk on your lunch break or scrolling through the yoga video options on Netflix and adding some to your queue. By making realistic changes you are providing yourself with an opportunity for sustainable life changes that will lead you to your goals. Try working backwards when planning- where do you want to be in 12 months? What goals need to have been met in 6 months for you to be on track to meet that year-end goal? How about in 3 months? Next month? Next week? break it down to doing one or two simple steps every day that will allow you to reach your objective in a measured and attainable way.

Finally, create your own cheering squad. Tell a few friends and family members (those who you find supportive) what your goals are long-term and how you're meeting them this week. Make sure you tell SOMEONE; this will make you accountable in your mind and will make it less likely that you will quit. Offer unconditional support to them on their goals and provide them with a sounding board for their challenges. It is my hope that all my patients will make realistic, sustainable changes in their lives in 2012 and will find themselves at the end of the year healthier and happier than they began it. Happy New Year!

I had the wonderful experience of going to a musician's memorial the other night. Dave Conant, a mentor to my partner and a friend to my partner's family, passed away ten years ago. His daughter, widow, and friends decided to hold a wild night of music and memories in his honor, providing a large part of Seattle's music scene an opportunity for remembrance and celebration of his life at Hale's Palladium, the venue for the local Moisture Festival. I only knew a very few people and was initially uncomfortable to be the odd man out, but quickly found myself enjoying the music and feelings of camaraderie I found there. It was a very touching tribute, telling me as much about his friends and family as it did about the man himself.

Last night, my partner and I got to talking about what he wanted to pass on to his son. I was thinking in terms of tangibles and he meant values and lessons. This led us to a discussion about parenting, me questioning the best ways to pass on lessons to kids at different stages of development, what values are important to pass on and how to get the message across. These kinds of discussions are ones I cherish the most with my partner; I learn more about him and come to respect him even more each time we talk about serious issues because of his thoughtful and thought-provoking musings. He had recently watched Pearl Jam's documentary "20" and came away with the idea that we, as parents, try to instill a set of "guard rails" to help our kids survive and thrive in society, but it's the kids who push against the guard rails at an early age that become breakout stars in their field.

I look around and see so many parents struggling for the fine line between being overly permissive and being resented by their kids by being too strict. I struggle with my own experiences with finding my niche in our combined family, developing a relationship with my partner's son is on my mind a lot. I love him to pieces, I want to be of support to him as he grows into a young man, I have the best intentions. Hell, I even have a degree in Human Development (with a focus on early child development) and a minor in Psychology and some of the time, it doesn't help a damn bit because I'm fumbling in the dark when it comes to our interactions. It's not my responsibility to raise him, to teach him my values. I understand that, but I also believe that as a human being I have a responsibility to be a good role model for any child in my life, be they family, friend, or patient. I feel honored that I have an opportunity to share experiences with some pretty special young people and I want to be a positive influence, something that helps them as they grow and learn to be good people.

Growing up, I thought my parents and grandparents knew everything there was to know about raising kids. I never questioned whether I was loved, I never was abused, I rarely even THOUGHT about disobeying them (though it's true that if there wasn't an explicit rule for a given situation, I might be found carving my initials in the bathroom door and blaming my sister for framing me). Now, I find myself missing my deceased grandfather because I feel he would be better able to get a handle on things in our house, he would know what to do to restore order. Or questioning my mother at dinner the other week, trying to find out what her secret was, how she got the three of us girls to do what she said almost every time just by lowering her voice and narrowing her eyes. How my father could tell us we were going to do chores and we just DID them. I never resented them and never questioned that they were doing the right thing, but I find myself envying them sometimes. How will I ever get a two-year old to put on clothes that are appropriate for the given weather? How will I keep a ten-year old from starving to death when he won't eat vegetables or food that doesn't come from a box? And, dear lord, what in the world can I do when my kids get old enough to date, to drive, to sneak out at night, to have SEX?!? What kinds of values can I instill in them that will keep them alive, happy, and successful in whatever way they define? How will I prepare them, share the best things that I've learned with them to help them in their lives?

Maybe it's too soon to be worrying about these things, without a child of my own yet, but I think it's good to have these discussions with myself, and with my family and friends, to continuously develop ways to live a life consistent with my values so that I can honestly say when I leave this world that the kids in my life knew who I was and what I stood for and that I made a positive difference in their lives.

Little ghosts and goblins are excitedly gearing up for Halloween in less than 2 weeks. We all remember how fun it was to dress up and rampage through the neighborhood, collecting candy and playing tricks. Some of us had the best houses mapped out or even descended on housing developments from our country neighborhoods to maximize our candy-collecting efficiency. From Madonnas to monks, clowns to crickets, witches to Wonder Women, many of us have fond memories of costumes that we wore year in, year out. 

This year, make sure that your kids are safe by following these rules from the Centers for Disease Control and Prevention : 

S- Swords and knives (and other blades) should be soft and flexible

A- Avoid being alone. Kids should be accompanied by an adult. If you feel your kids are old enough to go on their own, make sure they're in a group & check in frequently via cell phone or coming home every hour.

F- Fasten reflective tape. If your child will be trick-or-treating after dark, pick up some inexpensive reflective tape and attach it to their costume so drivers can see them better.

E- Examine all treats! Make sure everyone gets a filling dinner before going outside, so that kids are less likely to be tempted to eat candy before you have checked it out. Look at each piece of candy for evidence of tampering with the wrapper. Do not accept homemade candy from people unless you know them well.

One of the best websites for child (and adult) Halloween safety tips, www.halloween-safety.com, offers more in-depth advice, such as not going into strangers' houses, making sure that costumes are flame-retardant and do not inhibit vision or movement, fire safety with candles and jack-o-lanterns, and pet safety tips. It is a great resource for parents and I highly recommend it!

Lions, and Tigers and Bears, oh my! It's time for touchdowns, tackles, and tight ends. Whether you're watching your kids play, watching the pros, or playing the weekend warrior playing a pickup game on the front lawn or in the park, fall means football (and soccer) for a lot of people here in Seattle and across the US. Here are a few ways to add some healthy habits to your season!

Stretch! Get all those muscles nice and warm. Stretch your large muscle groups (upper legs- front AND back, calves, biceps & triceps, back muscles and neck muscles) to improve circulation and prevent injuries. Sitting on the couch through a Sunday's-worth of games can take a toll. Get up and move around, grab another glass of water, and keep moving. If you or your kids are on the field, warming up before the game is a MUST to avoid Monday remorse. 

Snack! Healthy snacks, like carrot sticks, orange slices, and peanut butter with crackers are perennial favorites for teams. At home? Add a twist to plain old chips and salsa by making a mix of shredded cabbage, diced tomatoes, onions, garlic and jalapenos to serve alongside. Buy the baked chips this time. Fruit plates, veggie trays with healthy dips like hummus, and chicken skewers instead of ribs and burgers are all great options that are lower in fat and calories. Chili is great, but skip the sour cream and mountains of shredded cheese & bacon bits.*

Drink! Water, that is. The more well-hydrated you are, the less sore you're going to be. Water helps remove waste products from active muscles, making for a more pleasant morning after the big game. Make sure to replace your electrolytes, such as sodium and potassium, which are lost when you sweat and can't be replaced by plain water. Healthy options, such as Recharge or Emergen-C are good alternatives to Gatorade and other electrolyte replacement drinks that use artificial ingredients.

Let's be realistic. Lots of folks like a beer while they watch the game. If you're going to drink alcohol, make sure you have a designated driver. Alternate each alcoholic drink with a large glass of water to avoid over-consumption (by filling up with water, you'll be less inclined to drink more alcohol to satisfy your thirst mechanism, and a stomach full of water will also help to stop you from eating the whole bag of chips by yourself). Know your limits. No one likes to deal with drunks at public sporting events or bars, so be aware of how much you're drinking. 

Have fun! Parents, remember that your kids are playing sports to have fun! Overcompetitive parents and those who argue with the referees, coaches, or other attendees are no fun for anyone. If you're playing, go with a laid-back approach. You're there to have fun, get some exercise, and spend time with your friends and teammates. Enjoy!

Remember Stone Turtle Health for school sports physicals (only $40 or insurance), therapeutic massage for sports injuries, and prevention.

*(Check back tomorrow for fall recipes that are great for entertaining during or after the game.)

Sunscreen. Sun block. Suntan lotion. What exactly is SPF? How much is enough? What is the FDA doing about it?

Now that we've (finally) got some sunshine in Seattle, it's time for a talk about sunscreen. Sunscreen is formed of organic and inorganic particles that are designed to block and/or absorb ultraviolet (UV) light from ths sun. Physical sunscreens reflect light, Chemical sunscreens absorb light. Many products have both forms inside. Blocking sunlight also blocks vitamin D creation, an issue that many patients have concerns about.

The SPF number reflects how well a sunscreen protects against UVB light, the type of UV ray that causes squamous cell carcinoma and basal cell carcinoma. It does not measure protection against UVA rays which cause melanoma or infrared light which also affects sun damage levels. UVB causes the most common types of skin cancer, but UVA causes the most deadly. SPF is, unfortunately, very inaccurate because most people don't put on enough. Also, wiping it off, swimming, and sweating all minimize its effectiveness, regardless of whether it is labeled "sweatproof" or "waterproof". Plus, we're supposed to be reapplying it every 2 hours, right? An SPF of 15 means that, theoretically, you're protected for 15 times longer than you would be without sunscreen. This, of course, doesn't take into account the changes in sun exposure throughout the day as the sun changes position in the sky.

The FDA has passed new regulations recently which will go into effect next year. These will require sunscreens to show that they block UVA and UVB rays in order to be labeled "broad spectrum" and only products with an SPF of 15 or higher can claim to prevent sun damage, wrinkles, and skin cancer. Further, no sunscreen manufacturers can label products as having an SPF higher than 50 because there is not enough evidence to prove that going above an SPF of 50 increases the benefit. The term "sunblock" can no longer be used, nor can "sweat-proof" or "water-proof". Instead, a product can be labeled "water-resistant", but then must state for how long, 40 or 80 minutes.

As always, staying out of the sun, avoiding tanning beds, and covering up with hats and long-sleeved clothing are very important in order to prevent sun damage, wrinkles, and cancer. If you're concerned about your vitamin D levels, talk to your doctor about alternate sources or about safer ways to get vitamin D naturally.

For more info:

Understanding Sunscreen Products - FDA

FDA Cracks down on Sunscreen Claims, bans 'sunblock'

What IS Sunscreen?

Skin Cancer, Sun, and Sunscreen

Last summer, the state of Washington amended our medical marijuana laws to include naturopathic physicians and nurse practitioners as providers who are legally permitted to write "authorizations" for medical marijuana use for patients suffering from a few very specific conditions. Since that time, I have worked with a number of patients who have had qualifying conditions and turned away even more folks who may have been suffering from pain but who just did not qualify or did not have the documentation to back up their claims of having qualifying conditions. Authorizations basically state that the doctor has advised the patient on the risks and benefits of medical marijuana and it is the doctor's opinion that the patient could benefit from using it. The law explicitly states that doctors cannot help patients obtain medical marijuana. Oddly, it's not illegal for the patient to possess medical marijuana, but it is illegal federally for anyone to buy or sell it. There are dispensaries, etc out there, but I can't tell my patients where to go. It's just a "Here you go, now you are allowed to treat yourself. Good luck finding some medication!" kind of thing.

One of my patients from last fall showed up in my waiting room last week. When I last saw her, my patient was recovering from brain surgery to remove a prolactinoma with associated pituitary apoplexy. In English, she had a prolactin-secreting tumor in her brain that had been causing bleeding in her pituitary gland, a tiny gland that sits behind the eyes and regulates most of the hormonal signals in the body. She was maybe 100 pounds, soaking wet, appeared very dizzy and disoriented, and was relying on her family to take care of her. She was only 28 and after I saw her, I went into my office and cried. I didn't think I had been able to do anything for her and she looked like she didn't have much longer to live. I wrote her an authorization, thinking that I would have written someone who was suffering like that as many authorizations as there are days in the week if I thought it would have done her any good.

Cut to 6 months later. She had been in to her oncologist's office to get fitted for a radiation crown, to begin irradiating the tumor that they couldn't remove surgically. A few weeks ago, in preparation, she had completed some imaging. When she got to the doctor's office, with a plan to see him every 3-6 months for the foreseeable future, she was told that he couldn't do anything for her. They had checked and re-checked, sent out for a second opinion and finally determined that there were no errors- there was simply no tumor visible in any of her scans. She was told by her oncologist that she no longer had to worry about radiation, about coming in every 3 months to poison her body in an attempt to gain a few more months. He said to come back in a year for a re-evaluation.

When she walked into my office last week, I hardly recognized her. There was no disorientation, no dizziness. She had put on enough weight and had such a healthy glow about her that she now looks like any other young woman walking down the street on a sunny afternoon. My patient told me that the only change she had made to her medication regimen had been to start creating and consuming capsules of hemp oil and hash oil mixed with powdered marijuana leaf. She told me of her oncology visits, that her doctors had told her they were going to launch studies searching for a link between tumor regression and medical marijuana. Most importantly, she told me that she is determined to enjoy life, to live each day in awe of the beauty that surrounds her, that she can find in little, everyday joys. We cried together a bit, and she promised me that she will be doing everything she can to get her story told, to bring more research money to help other cancer patients. Before she left, I was the one thanking her.

The good news is, she's not alone. Norml's blog entry talks about other research, dating all the way back to the 70's.

Today, I had a great day. I got to do something small that I hope will make a big difference for someone in my community.

Back in January, I decided to donate $10 to the Ballard Food Bank for every new patient that month. I met the Food Bank's Executive Director, Nancy McKinney, at a Ballard Chamber of Commerce  After-Hours event last year and have been looking for an opportunity to help her organization as it continues to support members of the Ballard community, including some of my own patients.  I felt like it would be a great way to show my gratitude for my expanding business while helping a worthy community cause at the same time. The Ballard Food Bank distributed over 10.2 million pounds of food in 2010; over 27% of their recipients are elderly and over 14% are children. They do good work.

And they've recently moved. They're now in a beautiful and LARGE space on Leary Way, south of Market Street, in Ballard. The warehouse has been divided into an office/reception area, staff offices, a delivery area and a "shopping" area where clients can pick their food as if they were shopping in a grocery store. Clients are allotted a certain amount of groceries, depending upon the size of their family, and can shop once/week for fresh fruits and veggies, unlimited bread, canned goods, and even flowers (on occasion). This new design allows clients to have more control over the food they are given (instead of just getting a basket that someone else has prepared).

The core volunteers are friendly and helpful and the food bank is always in need of more. Peggy Bailey is the Volunteer Coordinator. She works with groups and individuals who want to help, in order to fill gaps in the schedule and support the core folks who are there on a regular basis. On our visit, we met a volunteer who is there 3 days a week! Now THAT'S dedication to your community!

After a quick tour and some photos, we were on our way back to the office. I'm so glad we got a chance to visit and I look forward to finding more opportunities to help this GREAT organization.

 Times are tight for a lot of folks right now, but if you've got some spare cans, spare time, or a little bit extra in your paycheck that you want to put to good use- please consider the Ballard Food Bank- Neighbors Helping Neighbors.

Food bank with Nancy McKinney.jpg (866.71 kb)

Many of my pediatric patients come to see me after their parents are frustrated with conventional medicine. These kids might have a history of asthma that is getting progressively worse or more frequent, they might be suffering from eczema that seems to have been around since they were babies, they may have chronic achey ears, or they may suffer from seasonal allergies that make them miserable six months out of the year. Chances are, many of them are on asthma inhalers, steroid creams, frequent antibiotics, and still be treating symptoms with over-the-counter meds. To a one, their parents have been frustrated over their increasing symptoms and lack of effective treatment options for the underlying conditions.

In medicine, both Western and more holistic forms, there is something called the "atopic triad", which consists of asthma, seasonal allergies and eczema. Doctors find that middle ear infections (or otitis media) are an also-ran, cropping up in a number of children who exhibit atopic symptoms. Naturopathic theory suggests that all of these conditions have a common cause, or etiology, where an insult to the system expresses itself in multiple ways, in an attempt by the body to get it addressed. Many times, this initial cause can be as simple as introducing a food into the diet that is either an allergen for the patient or simply introduced before the body has an adequate way to process it.

For example, suppose an infant received cow's milk at the age of 3 months. If the baby's digestive tract was not fully functional, the larger proteins can cross the gut barrier and enter the bloodstream. Normally, the gaps between cells lining the gut are too tight for this to happen but if inflammation is present or they are not fully matured, proteins that would normally need to be broken down can pass into the blood whole. In this case, the milk protein meets some circulating immune cells and they, correctly, determine that it is a foreign protein. Now, immune cells are supposed to determine between foreign or host proteins, not determine whether a foreign protein is a friend or foe. If they do their job properly, they will create antibodies to the foreign milk protein as if it were a virus. One of the main jobs of the immune system is to cause inflammation in an effort to isolate the intruder until the rest of the immune system can arrive and fight it off. This inflammation includes gut cells, meaning that the gaps between cells remains "leaky", allowing more foreign food proteins to cross into the bloodstream.

Asthma, allergies, and eczema all have a strong inflammatory component to them. If that same child, whose immune system is diligently protecting her from milk protein continues to consume dairy products, the body might break out in a rash (the skin, lungs, and digestive tract are all major organs of elimination). The baby's doctor might treat the rash with a cortisone-based cream, reducing the surface inflammation and preventing itching, but not allowing the body to express the allergy. In naturopathic theory, this is called suppression and drives the body to express itself in a more serious manner, such as developing asthma or chronic middle ear infections. These can also be complicated by the immune system's major defensive mechanism of promoting mucus production.

In many patients, when we work on eliminating asthma or chronic ear infections, we see a resurgence of eczema as the body no longer has to resort to such extreme measures (asthma attacks, ear infections) to address allergens. If we do see eczema or another, supposedly past, manifestion occur, we know we are on the right track with treatment and are not suppressing the body's need to expel allergens or toxins. Once we determine the substance that the patient is responding to, we can eliminate it from the diet or environment and work on repairing the lungs, skin, and digestive tract. In some cases, patients can eventually re-introduce allergens into their diet once we have healed the digestive tract and calmed the immune system response.

I'm excited to announce that in the coming weeks, we'll be launching two new programs that focus on health education.

First, we are in the process of recording podcasts addressing health topics, such as diabetes and weight loss, in our new podcast. We're still trying out names for the show. If you've got suggestions for names or topics, send them to us!

Secondly, we're taking it on the road! Do you and your friends spend your time talking about common health concerns, like aging or child development? Would you like to have an expert answer questions on topics you're interested in? Stone Turtle Health and our associates are launching health education parties. Bring some snacks, have some wine, hang with your friends and get your health questions answered in the comfort of your own home. A safe environment to ask whatever you have questions about your family's health.

If you want more information or have suggestions for either of the above new programs at Stone Turtle Health, please feel free to email us via the Contact page.