This past week was a long and trying one for my entire family.
We thought that we had lost my mom. Without the quick, assertive
intervention of the paramedics, emergency room and intensive care
unit staff back home in western North Carolina, my mother would
have certainly died. With her permission, I am sharing this story,
how high force intervention saved her life, and where naturopathic
doctors fit into the care model, as I see it. The thoughts and
opinions expressed here are mine and are the result of my thought
process. This week's entry is a bit long and covers almost two
weeks worth of events.
In my blog this week, I'll do my best to explain how high force
intervention can be both a benefit and detriment under the proper
conditions, as can any type of medicine. Mom has a history of
asthma and heart disease and as a result was on a cocktail of 12
medications, without co-management between her various care
providers. Before I move on, I want to make the point that each of
these caregivers was honestly doing their best to care for her, yet
no communication was occurring between the caregivers on Mom's many
The story begins with my mother complaining of shortness of
breath while one of my sisters was visiting. After prodding from my
sister, my mom agreed to allow her to call 911. We are from a rural
area, so we have volunteer responders who can arrive either in
their personal vehicle or an ambulance. The first person to arrive
saw my mom fighting for breath. By the time he had gathered his
equipment, my mom was blue (cyanotic) and frothing at the mouth. He
immediately began CPR on my mother as she was now in cardiac
arrest. The ambulance arrived at this time, and within 90 seconds
the paramedics were helping my mom breathe with a ventilator.
She was immediately transported to Mission St Joseph's hospital
in Asheville, North Carolina, where the emergency room staff
quickly and accurately stabilized her. She was moved to the
intensive care unit shortly after being stabilized until her
caregivers could be notified and they could figure out what was
causing this episode. The quick, high force interventions of the
first responders and ER staff saved my mother's life.
To keep a long story short, an interaction occurred between her
many pharmaceuticals that caused a spasm in her diaphragm, the
primary muscle that helps us breathe through expanding and
contracting our lungs. Mom gradually lost her ability to get air,
and thus oxygen to the point that she lost consciousness. As a
result of taking many different medications without cross
consultation among her specialist caregivers, Mom had a reaction
that could have cost her life. At the same time, without high force
intervention, such as her intubation and respirator at the
emergency room, Mom could have lost her life. Again, I believe that
each of these caregivers was doing their best with the toolkit
available to them to help my mother be as healthy as she could be.
This is what medical caregivers are trained to do, regardless of
their specialty, field or modality.
Right now, Mom's medications have been reduced drastically, as
after review and consultation together, her specialists determined
that she didn't need as many medications as she was taking before
the incident. She is feeling much better and is excited to have one
caregiver managing all of her medications regardless of who
prescribes them. She has a great rapport with her cardiologist who
has been caring for her for over 15 years. Rest assured, I will be
watching her meds more closely now as well.
My sister Kristie, Ladybug and Mom earlier this
So, how does this relate to naturopathic medicine? This is where
my opinion comes into play, so from this point in this week's post,
I am sharing my viewpoint. I view my future role as a naturopathic
doctor as a gatekeeper. By gatekeeper, I mean the role of the
primary care doctor or central hub of care. If you imagine an ND as
the hub of a wheel, with spokes moving from the hub out to various
specialists such as endocrinologists, gynecologists, chiropractors,
physical therapists, etc., the ND can take information from each of
these specialists and incorporate that information into the 'whole
picture' of the patient, their care and their health. Whether in a
licensed or unlicensed state, the ND as the health gatekeeper, is
trained to know and understand pharmaceuticals and how they
interact not only with other pharmaceutical meds, but also with
botanicals, supplements and anything administered to the patient.
We are uniquely trained and qualified to act as our patients'
gatekeeper for their health and lives.
In closing this week, we as NDs are not the ideal choice for
high force intervention in most cases. With the exception of the
states where NDs have prescribing authority in that state's scope
of practice, we will not be involved in high force intervention
(i.e. prescribing or removing pharmaceuticals in patient care or
minor surgery/trauma etc.). We are trained more specifically for
chronic lingering illnesses and our moderate methods typically
don't have the overnight impact of a pharmaceutical. At the same
time, our interventions are much gentler and have a much lower risk
of a severe, life-threatening episode. I have a healthy respect for
those who are trained and adept at taking a person on death's door
and bringing them back time after time, day after day with the calm
precision of highly trained professionals. At the same time, after
my training here at NUHS, I'm convinced that not every situation
requires pharmaceuticals upon an initial visit. Perhaps, as we grow
as a profession and our allopathic colleagues become more aware of
our training and effectiveness, we will see a greater amount of
collaboration, communication and whole person care with NDs as the
hub and gatekeeper of a patient's medical care.
I'm elated that my mother's caregivers have agreed to her wish
of having a single doctor in charge of her medication list. This
cooperation amongst caregivers is unique and I think indicative of
the excellent care in western North Carolina as a whole. I'm happy
Mom is still with our family and hope to have her with us for many
years to come!