The Secret Ingredient

Every time exams approach, I do my best to thoroughly prepare by studying all of my notes a few times. Even with putting in hours of studying, the reality is that I will never know everything! I used to struggle with this fact, but coming to accept it and developing the secret ingredient -- intuition -- has helped my studying and exam-taking habits.

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Intuition can help get you through when you feel like you have nothing left to give. Using your gut instincts, even when words and concepts seem unfamiliar, helps access deeply stored information that you don't even realize you have. In a few classes, the idea of developing intuition has been discussed, not only for student-life but also to use in practice.

Intuition comes into play both during studying and test taking. When I study, I use my intuition to guide me in what questions or concepts are the most likely to be tested. I then spend more time on that material to memorize it, or I use techniques to connect the information in logical ways to easily access the information.

Intuition during exams is the second aspect. Since the vast majority of assessments at NUHS are multiple choice to prepare us for taking board exams, using intuition to sort through the remaining answers after eliminating some choices based on knowledge is better than randomly guessing.

This week I have three quizzes/exams in Botanical Medicine IV, Internal Medicine, and Environmental Medicine. I've been studying consistently for the past 4 or 5 days, but with the volume of information presented in every class, it's not realistic to expect myself to memorize everything. I always rely on my intuition, in addition to knowledge, to get me through!

Lyme Disease

2017-07-12_bookI recently did a presentation on Lyme disease in my Functional Medicine class based on a book the professor recommended (The Beginner's Guide to Lyme Disease), and I have a paper to write on Lyme disease epidemiology for my Environmental Medicine class. These two classes gave me the motivation to dive in deeper and learn more about treating Lyme disease so that I'm more prepared when I start seeing patients. Lyme disease is becoming more and more common, and those who have it are seeking out Lyme-literate doctors to get better.

I was surprised to learn that the Centers for Disease Control & Prevention's (CDC) surveillance criteria for Lyme disease designed for national reporting isn't appropriate for making a clinical diagnosis; however, it's misused as the standard of care for health care reimbursement. This contributes to under-diagnosis and prolonged suffering for patients with Lyme disease.

Diagnosing Lyme disease can be tricky for several reasons:

  1. Lyme disease is a great imitator of many other diseases.
  2. People may not remember or notice tick bites because the ticks that carry the Borrelia bacteria are the size of a poppy seed.
  3. The classical erythema migrans (bull's eye rash) only appears in about 50% of infections.
  4. Symptoms may not appear for several months after becoming infected.
  5. And additionally, there are several lab tests available, and a negative lab finding doesn't necessarily rule out the disease!

The book recommends that three tests be run as a panel (Western Blot, Immunofluorescence Assay, and Polymerase Chain Reaction) through a specialized Lyme-literate laboratory for a laboratory diagnosis that is accurate 95% of the time.

Treating Lyme disease is a long-term battle that often takes several months to years. Since the Borrelia bacteria can be in different stages inside the body (spirochete, cyst, and cell-wall deficient forms), it's important to treat all forms concurrently. Bacterial resistance is another complicating factor, so it's recommended to rotate antibiotics and botanicals every six weeks.

Now that I have some basic information on the diagnosis and treatment of Lyme disease, I'm going to start researching the epidemiology of Lyme disease for my Environmental Medicine paper. There is so much to learn, and Lyme-literate doctors are needed!

Fourth of July Weekend

This weekend was busy and filled with fun events! Luis and I went to Manitowoc, Wisconsin, (my hometown) for a mini-vacation to relax.

On Saturday, my godmother hosted a baby shower for me with my dad's side of the family. A lot of my Florida and California relatives were in town, so it was a large group and a lot of fun! That evening, one of my cousins had the rest of us cousins over for a campfire at her house.

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Then, I had another baby shower on Sunday hosted by my sister with my mom's side of the family. It was a relaxing BBQ get-together, and we were lucky to have good weather during the event despite heavy rain in the morning. In the evening we had a bonfire with all the neighbors.

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I'm writing this blog post on Monday, and although the school is in session, both my classes today had independent study days -- I have to complete an online quiz for my Pediatrics class, and turn in an assignment for Botanical Medicine IV. Therefore, we are still on vacation and will spend more time with family tonight. Tomorrow, July 4th, we will return to Lombard, hopefully avoiding too much holiday return traffic! We might even watch the fireworks at Madison Meadows Park a few blocks away if we have the energy for it.

The summer months are always busy but it's nice to take time off for "vitamin R" -- rest, relaxation, recreation, and rejuvenation.  

Homecoming 2017

Over the weekend, I attended NUHS Homecoming thanks to a generous donation from 1957 alumnus Dr. Titus Plomaritis, who sponsored several students to attend the celebration. This was the first year that there were separate DC, ND, AOM, and massage therapy talks, and I think they went well! It's always hard giving up three days of a four-day weekend, but I was inspired to hear Dr. Paul Epstein, one of the elders of the naturopathic profession, talk about the mind-body connection. 

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Naturopathic doctors and students with Dr. Epstein after his final session.

Dr. Epstein had us start and end each morning with meditation, as he does with many of his patients. We learned about a lot of research that shows a strong connection between chronic disease and unresolved adverse childhood events and traumas. As naturopathic doctors, one of the principles is to treat the whole person, and part of our philosophy is to identify the root cause of disease. Therefore, recognizing the importance of the mind-body connection and how the body can physically manifest past emotional traumas is a key piece in helping patients get well. 

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Dr. Plomaritis and a few of the students he sponsored.

Getting to know Dr. Plomaritis was also a highlight of Homecoming. He first introduced himself during the mentorship session, and many of the students he sponsored including me got to know him better over lunch. He shared amazing personal stories about his life, and about advancing the chiropractic profession by his work influencing politicians, including President Jimmy Carter, which had lead to removing a controversial clause in the National Health Bill, which would have prevented people from seeing chiropractic doctors without a referral from a medical doctor. His stories and enthusiasm peaked my interest in reading his autobiography called "Titus," for which he hopes to become a best-selling author.

Forest Bathing

Last week in Advanced Nutrition and Functional Medicine, students were assigned to read a research article from Japan on forest bathing. Many people already know that being in nature is good for you, but this research study analyzed specific markers to validate its therapeutic effects.

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Forest Bathing in Morton Arboretum

The study took place in 24 forests in Japan with about 280 research subjects who first walked in and viewed either a forest or city area. The second day, they went to the other location. Health markers measured in both settings included blood pressure, heart rate, heart rate variability, and salivary cortisol.

The results showed that being in the forest reduced blood pressure, heart rate, and salivary cortisol, and it increased heart rate variability. All have positive effects on the body. It also increased parasympathetic ("rest and digest") nerve activity and decreased sympathetic ("fight or flight") nerve activity.

In our class discussion, some opinions shared about this research study varied from those who loved it to those who think it is a waste of time. Several students loved that there is hard data on the therapeutic effects of being in nature to show patients who are skeptical about how something so simple will help them reach health goals. It also contributes to evidence-based medicine, something that the conventional medicine model values substantially. Others didn't like the article because they thought it was absurd that something like this even needed to be studied considering humans have lived in nature without city settings for thousands of years, and that nature is our natural habitat.

I enjoyed the article and it validates what I have found to be true through personal experience -- being outdoors in nature can benefit health and well-being! Have you gotten your daily dose of nature yet?