Tim's Blog

This past week we were introduced to two of the more interesting classes I have taken here at NUHS over the past three years. These classes are Minor Surgical Techniques and Environmental Medicine. 

Minor Surgical Techniques is perhaps our best example of medicine's greatest force of intervention, while also following one of the Naturopathic principles of "do no harm." The task of bringing injured tissues together (so that they can heal more completely without complication) while piercing that tissue with a needle and suturing material (some tissue damage in order to help the whole person heal) can help prevent local infection building and possibly invading the circulatory system, where it can infect the person's entire body. 

While many of us will never use the procedures taught in minor surgery, some of our licensed states require that the naturopathic physicians in that state be able to perform all procedures that a primary care doctor would perform in their normal duties. 

Environmental Medicine is a review of the "total load" of today's environment upon the human body. We look at all sources of toxins from our food supply, items of everyday living, air, water and electronic sources. We measure the impact of these sources upon the human body, both in the short term as well as over a lifetime. We research ways of detoxifying the human body from these influences and ways of helping the human body, mind and spirit recover from an overload of toxins. 

These classes roll up many of the concepts we learned in the basic sciences portion of our curriculum from anatomy, inflammatory process, tissue injury and healing, our bodies' built-in filtration systems and just about every process we learned. Now, as I have said before, the concepts are being applied on a daily basis, both in our classes as well as when we see our patients at the Student Clinic.

In Memory...

Finally, on this Memorial Day weekend, I'm taking the bully pulpit of this blog to honor two of the veterans who have given their lives for our country, our freedoms, our people--not just for their generation, yet for those who follow, both born here and who immigrate here for a better life. These men are my uncles: U.S. Army Private First Class Edward Ammons, who was killed in action in 1945 on Luzon Island in the Philippines during the waning months of World War II after having fought much of the Pacific Campaign; and U.S. Army Private First Class Otto Ammons, who was killed in action in early 1952 near the 38th Parallel during the Korean War. Our family has never forgotten them and I will do my best to ensure that none of our veterans who have given their lives willingly for our country and innate liberties, regardless of the war, action or operation are forgotten.

Well, everyone, now is the time to close out yet another trimester of classes. Next week is finals week and we will have a two-week break before returning the second week in May. 

This trimester has seen some short-range changes in schedule, work and diet in order to affect long-term outcomes for the better with regard to clinical learning, finances and health for years to come. 

The classes this trimester have been brutal with the workload between exams, quizzes, papers, presentations, prescribing, assignments, and attendance. At the same time, I feel like our studies have come full circle and we have applied all of the facts that are thrown at us in the basic sciences portion of our studies.  We have prescribed, differentially diagnosed, treated and critiqued both our own work as well as that of our classmates. We have delved into complex topics such as the impact of biofilms on the human organism, the impact of an improperly functioning methyltetrahydrofolate reductase (MTHFR) enzyme and its necessity within the human body as well as the efficacy of liposomal delivery of supplements, just to name a few topics. 

When I took a firm look at my finances currently and projected them to graduation day, I knew I needed to take action to change the situation. When assessing the income opportunities while attending medical school, I weighed staying on a "full tilt" schedule versus slowing down to finish classes before clinical rotations and working a part-time job. Finally, mapping out the resources necessary for moving back to North Carolina, gaining a residency position or joining a practice, allowed me to be prepared for any situation I could think of. Of course, things may come up or ideas may come about that I didn't fathom before. This is when I will take time to pause, reassess and adjust the plan as conditions warrant. 

My diet has changed for the better. I have established the habit of taking a long hard look at the foods I put into my body. I have had to make some hard decisions as eating healthy, organically produced whole foods is a bit more expensive and time consuming to purchase and prepare. I plan my shopping trips better, don't waste time or fuel on multiple trips to the store, all while maintaining enough food without it going bad. Disclaimer: I have tripped up a couple of times when I felt rushed or simply too lazy to take time to cook properly. Good lesson for future patient care and "patience with patients" in there somewhere. :) 

I suppose the primary thing I have learned from the last 15 weeks is that we can accomplish what we need with the resources at hand. We simply need to look at our options, see what is available, then map, develop and proceed with the plan. Take a few stops along the way to measure progress, reassess direction and make changes if necessary. No rigid dogma required; flexibility and ability to admit error is key, as long as corrections (and progress) are made. I'll be working, then heading home to western North Carolina for the break. I'll definitely catch up with family and friends back home, do some work around the property and relax mostly. I hope each of you has a wonderful spring season! See you next trimester when I will be entering clinical rotations (for certain this time!) and sharing a bit about the "clinic life"!

In the spirit of getting by and excelling with what one has, here is a pic of two early ducks in a tiny puddle on campus after a rain and a quote from Ralph Waldo Emerson! Make do with what lies "within"you, develop and excel those traits and be your best! 

What lies behind us and before us are tiny matters compared with what lies within us. -- Ralph Waldo Emerson

Well, this week has pretty much been the same as every other week of eighth trimester classes. This is a short synopsis of the past week prior to my blog entry. A very heavy workload with quizzes three of the five days, two presentations along with another paper due (this is the busiest and I think it's a bit downhill from here). 

The presentations this week consist of the impact of various heavy metals and their toxic impacts upon the human body's systems; as well as an informative presentation describing the method of naturopathic medical approaches. The heavy metal presentation is presented at the level of medical professionals while the naturopathic medicine presentation is constructed for use with the average person after I open my practice. 

The hat is a shout out to my 84-year old dad, Roscoe Ammons, who is
still working a full 40-hour workweek at the recycling center at our home
in Madison County, North Carolina. (Also, note the shirt; it says it all!)

The heavy metal topic, prepared for presentation in my Functional Medicine class takes a look at three metals we encounter every day, their function in our lives, what constitutes a toxic load (or dose), the vector of entry and impact upon the human body, as well as testing procedures and remediation methods, if possible. This was a huge undertaking! I had to scale down to three metals (not including mercury) and the presentation will still be around 45 minutes long. 

The presentation on naturopathic medicine for my Practice Management II class centers on the philosophy (or five principles) and therapeutic order of naturopathic medicine. The presentation describes what is NOT naturopathic medicine, then follows with the principles, therapeutic order and how a properly trained naturopathic doctor would apply the therapeutic order to treat an illness, including referral to a specialist, where necessary. I feel that this presentation will be quite the useful tool for presenting to local clubs, libraries and groups for building my future practice. 

This is about as exciting as things get right now everyone. I said it before, and I'll say it again, I heard all the rumors about eighth trimester classes being relentless with work and I chalked it all up to hearsay and drama. This is not the case. Be ready for your eighth trimester here at NUHS. Topics are more deeply covered, subjects are relentlessly probed, topics are researched ad nauseum, and the feeling of learning has never been stronger! The light is at the end of the tunnel! 

Until next week, here's a little something from Henry Wadsworth Longfellow:

Perseverance is a great element of success. If you only knock long enough
and loud enough at the gate, you are sure to wake up somebody.

Keep on kicking everyone, spring is technically here! :)

As spring approaches, I like to watch for the early signs of warmer weather. The flowers sprouting from the earth, the trees as they begin to bud, and the sandhill cranes as they migrate back north over our campus--the surefire sign that spring is finally here... or nearby anyway! 

Part of becoming a doctor is to learn to observe our patients before we ever palpate, percuss or test motion. We observe the patient's patterns of movement, any visible signs of distress. As we begin our intake, or conversation, with the patient, we observe how they communicate, their story. As we begin the examination, we observe the patient's skin, hair and nails looking for any sign of illness or injury. 

This is where our dermatology class helps with our examinations. As we progress through the program, dermatology is interspersed throughout the curriculum, introducing us to various conditions presented on patients' skin and other visible areas. We are introduced to macules, papules, nodules, patches and furuncles from the early days of our program until it finally culminates in the dermatology course in eighth trimester. 

By the time we are finished with this class, we will be able to know the pathologies that are associated with acrochordons (skin tags), eczemas, contact dermatitis, boils, papules, etc. Each class, now that we are in the clinical sciences portion of our studies, puts together all the pieces of our basic science 'data driven' classes. We are applying the principles into larger concepts and drawing conclusions based upon clues that we can see, examine and test, just as any good healer would do. 

Speaking of signs, the sun is coming up and I have another presentation to do! Eighth trimester is full of presentations, papers, cases, etc., as I have mentioned ad nauseum the past few weeks. 

Here is a picture of some of the tulips on campus sprouting through a dusting of snow we received this weekend. They present an excellent lesson in perseverance! 

Until next week, may your journey be light and you keep a happy heart with a big smile!

This past week has been an expansion of my efforts I listed for you in my blog. 

As an example, I just completed a presentation for my Advanced Botanical Prescribing class to be presented next week. The presentation is a review of the cardiovascular drug, digoxin, along with referenced studies of botanical interactions on the efficacy of digoxin's function in the human body. I chose to focus on three botanicals. These are Hypericum perforatum or St. John's Wort, Withania somnifera or Ashwagandha, and Crataegus oxycantha or Hawthorne. The interactions between digoxin and these botanicals were surprising and warrant further study. I'm sure my classmates will be interested in the findings I present next week. 

Many people take botanical supplements alongside their pharmaceutical prescription drugs with the notion that botanicals are all natural, not chemically derived, so they must be inherently safe. What most don't realize is that botanicals have chemical constituents that impact the human body and can interact with pharmaceutical drugs by either increasing or decreasing the drug's effect, to keep things simple for our purposes here. Pharmaceuticals are prescribed for specific reasons and should never be tampered with by altering the prescription or adding supplements unless under the direction of a licensed provider. This goes for the patient, friends, family, or those who wish to help yet may not understand the impact of what appears to be friendly advice. 

With the exception of the myriad reports, presentations, reviews, quizzes, and exams that are typical of eighth trimester, my week has consisted of work, and a short break to the theatre to see a movie. While things are a bit tedious right now, I'm certain once this trimester is completed and "in the books" so to speak, I'll be able to get out and about and let you guys know a bit about the area this spring and summer! I can't wait for some nice warm spring days to get to the lake and enjoy the scenery! 

Until next week may your springtime arrive and the birds wake you with song!