A Student's Role in ND Licensure

I was a little too busy writing about hydrotherapy last week to comment on the election we just had. I hope that those of you who can vote, did so! I heard that only 1/3 of eligible Americans voted. I understand that political showmanship isn't cool and that the attack ads we hear and see are sickening, but I'm still not quite convinced that the proper response to this political climate is to abstain from voting.


I am not politically inclined, I haven't studied the subject, and I don't know enough about the people I vote for. I do listen to public radio news a lot, and I read news headlines, but I do not own a TV, so my information-gathering tactics may differ from most. I find it strange that 2/3 of the people from a country that fights fiercely to initiate democracy in other places around the world, would not show up to the polls. I am especially puzzled because these mid-term elections for local government seem to be the truer way to impact our greater (seemingly untouchable) national government. OK, that's all I'll get into on this last election, but I mention it because it's relevant to our naturopathic profession to be somewhat politically active and versed in how local government works.

Map from http://www.naturopathic.org (click to see larger version)

It's no secret that naturopathic medicine is not licensed in Illinois, or in the majority of the United States. Currently, 17 states, Washington D.C., Puerto Rico and the U.S. Virgin Islands license or regulate naturopathic medicine. Our under-the-radar practice of healing impacts our education because we have to tread lightly when advertising our work at the NUHS clinic. Yes, we are trained to diagnose and treat disease, but we are not allowed to officially exercise this training as naturopaths here in Illinois. Our training encompasses many things that we are not yet licensed to do in many states, but we learn these things so that we are prepared to safely and effectively treat patients when the time comes that our scope of practice does include these skills. I have confidence (as do many others) that this time will come; our national state of health is ripe for our medicine.

As far as I understand, all the clinicians who oversee our ND clinic here at NUHS are also licensed chiropractors, and we practice under their license while we work to gain licensure here in Illinois. For those of you looking to attend NUHS to study naturopathic medicine, please do not let licensure get in the way of your decision-making. I personally chose NUHS because of the realistic environment it would provide for practicing my medicine. I do not know where I will land and I want to feel prepared to offer my services to my community, no matter the political state of naturopathic medicine in that place.

If you're curious about the process and progress toward licensure in Illinois, I encourage you to explore the Illinois Association of Naturopathic Physicians website. Also, contact your local legislator and share with them your passion that naturopathic medicine be a licensed profession. Legislators care about what their constituents care about. They want to hear from the people they represent. Your senator wants to represent your opinion and address your concerns more so than they want to hear from a group of naturopathic doctors about how much our medicine is needed by you, the people they represent.

If you are a student at NUHS, you should be a student member of ILANP. The cost is minimal and makes a big impact. When the ILANP lobbies for licensure, greater numbers help their cause, and their work in lobbying for licensure directly affects us as students. If you plan to return to another state after graduation, I highly suggest you join that state's naturopathic association, too. And, of course we should all join and support our American Association of Naturopathic Physicians. Again, greater numbers show involvement and promise when these associations work for our future practices and safe access to our medicine for our future patients. Plus, there are perks with every membership! (I get a free access to diverse naturopathic resources through my AANP membership, and I received a welcome discount to the ILANP conference this year!

I may not fancy supporting the current caustic political environment, but as an ND student, I understand that local politics are wholly relevant to my future. If I don't keep informed, I run the risk of envisioning for myself an unrealistic future. "OK, OK, now," some of you are saying, "but what IS reality, really? Isn't it what WE make it to be?" I'm not getting philosophical here. I'm being present and encouraging my peers to do the same. Let's show our support for our profession and those who are working (some unpaid!) to elevate our medicine and make it known, safely accessible, and properly understood.

What Is Hydrotherapy Part 2: How and Why

A few weeks ago I introduced the topic of hydrotherapy in this post. To learn about the basics and some of the history on modern naturopathic constitutional hydrotherapy, please refer to my last post. Once you're caught up, let's continue! How and why do naturopathic doctors use water as a therapy?

Water is known as the universal solvent, and it stores and transmits heat better than any other substance, by weight. The physiological effects of water on the body fall into three categories: thermal, mechanical and chemical. Thermal application involves changing the temperature of the body based on using water that is either hotter or colder than our normal body temperature. The mechanical effect of water on the body involves physical impact on the body in the form of frictions, immersions, whirlpools, showers, sprays, etc. Water's chemical effect on the body involves ingesting water and receiving water internally by irrigation (such as colonics.) The category we use most frequently in naturopathic practice to elicit physiological change is the thermal application of water.

The temperature ranges used in hydrotherapy are in relation to the body temperature of the patient (healthy body temp is around 98.6º F). When we use cold applications (32-65º F depending on intensity of treatment and/or patient tolerance), we are depressing function via vasoconstriction (narrowing of blood vessels), which slows blood flow. Decreased blood flow means that fewer immune cells are activated in local tissues and metabolic activity decreases, leading to a decrease in sensation (cold nerves do not transmit signals as readily) and a slower motor response of muscles due to slight contraction (tightening.) In this way, we can control inflammation, a technique that is used to treat pain as well as ligament sprains and muscle strains. These are injuries that cause the body to react with excess inflammation.

It is important to note that our body creates inflammation for a reason; increasing blood to an injured area brings more immune cells and repair ingredients to the area. We always want some degree of inflammation present if we want the body to heal, but our body can respond in excess and we may want to control it for our comfort and to elicit the smoothest healing process.

If we apply cold therapies in a general fashion (such as a cold sheet wrap or soak), we cause blood to move to the core as the whole body cools. We rarely use such applications, but might apply this in treating an exceedingly high fever to bring down the body temperature.

If we apply cold for a short amount of time, we can elicit a "reaction" effect, which causes a reflexive increase in blood flow and heat production in the area when the cold is removed. This makes the patient to feel greater "vigor and well-being." We use this application of cold more often in practice.

Alternately, hot water applications elicit responses from the body as it tries to clear the heat. This includes vasodilation (opening up of blood vessels), increased blood pressure and respiratory rate, and increased local metabolic activity. It also causes immune cells to become more active, muscles to relax, and sweating to occur. The reflexive response of removing a short use hot application causes the body to relax. 

Hot application used alone can also be cleansing and detoxifying, but care is always taken to monitor the patient and make sure they do not over-heat. An example of this is the peat bath I experienced in hydrotherapy lab last week, pictured below! I sat in this bath of about 106º F for 20 minutes and gotreallyhot. Afterwards, I was given water and wrapped in a dry sheet to continue to sweat as I slowly cooled after the treatment. The experience was extremely detoxifying, intense, and relaxing. While I had a headache later that night following treatment, I felt fabulous the next day!

Sweating and smiling in a peat bath

When used in therapeutic application (not for too long or for too short and in appropriate alternations - this is why we require a course in this therapy!), cold is stimulating, invigorating and tonifying, while hot is relaxing and sedative. Naturopathic hydrotherapy often uses hot therapy in combination with cold therapy. We can use alternating hot and cold treatments (contrast) to increase or decrease blood flow to an area to promote healing. I practiced administering a contrast bath recently in class for my classmate Brad, whose feet had been hurting from long-distance running. Affecting blood flow is one of the major goals of hydrotherapy. The purpose of directing or moving blood flow is to increase oxygenation, deliver nutrients and immune factors, and clear toxins from tissues. This process is best elicited when combined with proper nutrition and detoxification, two important components of naturopathic practice.

Brad receiving a hot and cold contrast bath treatment

A naturopath always monitors the temperature, pulse and respiration rates of the patient before, during and after treatment to ensure that we are eliciting the proper effects, and that the patient is safe. Additionally, we always consider the age, severity of illness/vitality, emotional state, and circulatory condition of the patient. A patient with heart failure is not a good candidate for a therapy that heavily influences blood flow. Young patients or very old patients require special consideration, for example, decreasing the variation range between cold and hot applications so as to make for gentler treatments. 

Fellow students monitoring blood pressure during treatment

One important aspect to practicing hydrotherapy is to never cool a chilled patient. In any situation, a patient should never get chilled, and following treatment the patient should not get too hot, too cold, or exercise vigorously, as the treatment may not have its full effect.

Not only is hydrotherapy effective and relatively cheap to administer, but also water is non-toxic, so we can use this therapy on very sensitive patients. There are many other ways to use water therapeutically and I cannot do every method justice here! One major application I left out is the use of neutral temperatures such as dry sheets wraps and neutral baths. Know that there is a lot more to explore and to study when you take the class offered here at NUHS! I hope this post helps to clarify hydrotherapy, and gives my fellow students some words to use in explaining this modality to their curious friends and family.

Sources: Pizzorno and Murray. Textbook of Natural Medicine. 4th edition. and Conner K. Hydrotherapy Lecture Notes. 2014. 

Finding Time for Art

Happy belated Halloween! I think once Halloween has come and gone, fall has really shown itself and we're officially getting closer to winter. Winter's impending presence is evident around here; it has been in the 30s at night. Brrrr! We even had our first snow last week!

First snow! Early morning on campus before classes began on Halloween day.

To celebrate Halloween this year, Hanzi and I went out to support the arts in Chicago. We saw a creepy opera put on by the Third Eye Theatre Ensemble called "The Medium." The show is about a woman named Madame Flora who scams customers by putting on fake séances with the help of her daughter and a "deaf and dumb" boy she has taken under her wing. When Madame Flora feels icy cold hands grab her around the neck at one of her séances, she gets terribly scared, admits her dishonesty and tries to give the people their money back. But the couple and the mother who have been coming to her séances to speak with their deceased children are convinced that Madame Flora has truly helped them to connect with their lost loved ones, and they fight her on her claims. Her customers say they know the voice and the laugh of their dead children and she must continue to help them connect with their dead!

The story is lots of fun and this particular show was put on in a black box theater, with two rows of seats along two of the walls. It was incredibly cool to feel that we were participants in the events taking place in Madame Flora's parlor.

I left this little rhyme outside our door incase we had any trick-or-treaters come by while we were out.

It is really very easy to forget our creative side when we are so busy with school, but taking the time to either make art or appreciate it brings me so much more alive! This is something I speak with my other student friends about often; when we're really dragging we encourage each other to go create something or find something artistic to enjoy. The experience of using the other half of our brains seems to really help put everything back in balance!

On the set of "The Medium"

After the Halloween show, as Hanzi and I hustled through the freezing rain back to our car, we had to make a stop at a bookstore called Myopic Books. It was 10:15 p.m. and the glowing red 'OPEN' sign in the window was intriguing. The place was packed with books from floor to ceiling, some narrow shelves constructed from raw 2x4s made for several narrow halls and fantastic browsing. The whole place was 3 stories, and packed with used books! I bee-lined to the third floor and parked myself in front of the alternative health section. Our spur-of-the-moment stop at this shop was totally worth it; I found a copy of "Women's Encyclopedia of Natural Health" by Tori Hudson, ND, know as THE women's health doc in naturopathic circles. And it cost me less than 10 bucks! There were signs inside the store asking us to not take photographs, so I had Hanzi snap this shot of me outside on our way out. The blustery, seriously chilly night combined with the red light in the window made for an appropriately spooky setting!

My fab bookstore find! On Halloween night at Myopic Books in Wicker Park.
(Photo credit: hanzi d. - www.hanzid.com)

After our artsy and interesting Halloween night, I am inspired to seek out artistic endeavors in the midst of my studying. Maybe I'll doodle when I'm losing focus in class, or maybe I'll take more creative pictures on my short walks between buildings on campus. I do really love to patronize the arts; this is perhaps the best use of my time (and money), as I don't really trust myself to find time to follow through on my own creative projects in the midst of med school. Now that I think about it, I have been getting more exposure to the arts... Just last week Hanzi and I went to a show at Cole's Bar in Logan Square where several hard-rocking local Chicago punk bands covered other awesome bands like Led Zeppelin (my absolute favorite!), Bikini Kill, and LCD Soundsystem. It was such a treat to lose myself in the music, all the while surrounded by people who sought out this show to do the same exact thing.

If I can't enjoy and create art on a regular basis right now because I am too busy studying medicine, I can at the very least let the little exposure that I do get to the arts fuel my studying. I'm writing this on Sunday, and am feeling totally ready to sit down and dig in to my Phys Dx lectures in preparation for this week's exam. I realize that I've had a good fill of art lately, and it would serve me well to remember, over the next year or so of school, how it truly helps to balance my brain.

Examining Place - The Midwest

Ah, sigh. This weekend I finally got away into the outside world where the air is significantly different from here in Chicagoland. I took in gulps of fresh air and smiled. I experienced my first corn maze in the flat, flat Midwest and sat under a tree whose red leaves came drifting down into my lap as I chewed my apple brat. I ate a candy apple, but we didn't get to pick our own apples because we were a little too late in the season for that.


These past two weeks, for some reason, I've found myself answering questions about my life before medical school. People have been asking about the places I've lived and the cultures there. I'm quick to tell a story about places outside of the Midwest, so this weekend's little adventures served as a good tether to pull me back, and to examine my current place.

When I was studying non-fiction writing in undergrad, we often examined the concept of Place and wrote on the topic: what does it mean to be in a place, what makes a place yours, not yours, different, the same, why sit and become enveloped in this place now? It's a damn hard task, to sit patiently in place and observe it for what it is. This is especially difficult when your world moves so quickly and you are expected to work hard at attaining, achieving, getting there, making progress towards becoming a doctor.

Despite the rapid clip at which I am working to become a doctor, I try, try, try to slow down and observe this place, to take it in and notice the unique things. This weekend helped me to settle and gaze, to take in the flat farmland, to hug my boyfriend, to laugh with new friends, and to read through old physiology notes in order to refresh my memory and help me be more present in my current classes.


When you talk about the Midwest with anyone, they inevitably say something about how nice people are here. My initial experience with this Midwestern friendliness involved some confusion, seeing as I come from Boston, a place where nobody acknowledges anybody unless they definitely want to talk. When I arrived in Chicago, a stranger would smile and ask me, "How are you?" I inaccurately perceived this as an open invitation for a full conversation. Over the past two years of living here, I've learned that friendliness does not necessarily equate to a desire to have a conversation, they're just being kind, I guess. I'm still a little weirded out by this; if you ask me how I'm doing, I still look at you sideways to figure out if you actually want me to answer that question, or not. On the other hand, my rather immediate assumption to jump into conversation has served me well, and I've made friends with shop clerks at nearly every place I buy goods and services.

Right now, the Midwest is my home, though perhaps not my truest Place. Here in Chicago, I've had to stumble along trying to navigate the culture, and I finally feel that maybe I'm able to catch these Midwesterners in stride and keep up. I have learned so much about life in the heart of classic America by living here. My greatest adventures so far have been getting to know a place by living in it, participating in the community, and feeling out the social habits of the people there. From this perspective, it's no wonder I feel so slammed with new information; it's not just the study of medicine I've been trying to assimilate, but the Midwestern way of life as well.


So being in medical school is more than just your peers, your books, your lectures, and the other trappings of studying medicine. Many of us move to a new place to start this journey into medicine, and the culture of that new place also provides us with struggles and triumphs. If we can find the time to sit with our new place, in addition to our books, we'll learn more about the world, which will certainly make us better doctors, right?

What is Hydrotherapy? Part One

When someone asks me about naturopathic medicine, I invariably list off several of our modalities in an effort to explain my training, and hydrotherapy usually comes up. Their next question is usually, "And what is hydrotherapy?"

I'll admit, until this trimester I wasn't very good at explaining hydrotherapy. I would more or less answer with, "Well, I'm not really sure because I haven't had that class yet." This is the first post I will write as part of an attempt to accurately answer the question, "What is Hydrotherapy?" In the process, I'll examine why I am so drawn to this particular tool in the ND's toolbox.

Here I am administering a constitutional hydrotherapy treatment
fellow ND student Lisa in our Friday afternoon Hydro Lab.

In naturopathic medicine, we recognize the body's ability and tendency toward self-healing. We call this the vis medicatrix naturae. The vis is the built-in guide we all have that allows our bodies to move "toward the healthiest expression of function," aka a healthy state of being (Pizzorno and Murray). Assuming that we provide our bodies the proper environment, we should be able to achieve a healthy state because theviscan work free of encumbrances (like fast food, unhappiness, too much beer, not enough sleep, or not enough love, to name a few.)  Hydrotherapy, specifically constitutional hydrotherapy, works by stimulating this self-healing mechanism, the vis.

This photo and the rest below are from a display in the library about
the history of medicine. I love these old images depicting hydrotherapy treatments!

So what is constitutional hydrotherapy? The quick definition, as supplied by Pizzorno and Murray in the Textbook of Natural Medicine, states that it is a simple procedure "involving the placement of hot and then cold towels on the trunk and back in specific sequence (depending on the patient), usually accompanied by a sine wave stimulation of the digestive tract." The treatment "recovers digestive function, stimulates toxin elimination, 'cleans the blood', and enhances immune function." All of these actions serve to move "the system along to a healthier state."


Hydrotherapy in general is defined as "the use of water, in any of its forms, for the maintenance of health or the treatment of disease." This can include application of water to the body via "sprays, douches, frictions, immersions, whirlpools, steams," etc. Modern research on hydrotherapy techniques for the treatment of disease is lacking because, I suspect, water exists already and no one can make a buck on redesigning it; it's pretty good as it is. Maybe someday when we truly encounter its scarcity, someone will study it. Or, maybe when Big Pharma dies. Or, when pigs fly. 


Anyways, before I get too much further into the what, let's examine where our modern naturopathic hydrotherapy came from. Much of the information we use for the basis of today's naturopathic application of hydrotherapy comes from centuries of clinical evidence, recorded and compiled by various healers over hundreds of years. Dr. O.G. Carroll, an ND who practiced in Spokane, Washington, may be considered the grandfather of modern naturopathic Constitutional Hydrotherapy in the United States, having been the one to add the sine wave stimulation. He studied with several storied and experienced hydrotherapy practitioners including Dr. Henry Lindlahr. Dr. Lindlahr practiced hydrotherapy at his Nature Cure (a name for the medicine that preceded the word naturopathy) sanitarium in Elmhurst, Illinois from 1914-1928. I should note, of course, that Lindlahr's School of Natural Therapeutics (again, a forerunner to naturopathy) was absorbed by the National College of Chiropractic (present day NUHS!) in 1926. 


There is so much more I could share about the rich history of hydrotherapy, but I would be hard pressed to do it justice. One book I have explored is Nature Doctors by Kirchfeld and Boyle. Though the book is rather dense and doesn't really read like a story, it definitely is a good source for learning about the history of our profession. I have also sought out books written by Henry Lindlahr and those by his son, Victor Lindlahr, on Nature Cure and Natural Therapeutics. The Textbook of Natural Medicine by Pizzorno and Murray that I referenced several times in this post has a whole chapter on hydrotherapy that I have yet to finish reading. I know there are so many more books out there, too, just waiting patiently for me to finish school and find the time to devour them...feel free to point me in the right direction if you have any suggestions!


I guarantee I've missed a lot of detail here, and I encourage you to fill in the gaps as you explore and study our medicine. Next time I'll focus more on what hydrotherapy actually does to the body, and why this makes it a useful therapy. Until then, have a lovely Week 8!  I hope everyone's midterms are going smoothly!