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!
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
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
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.
Just a quick note this week to wish all of you a very Happy
Thanksgiving! I'll share a bit of what I am thankful for this
I am thankful for my family. My parents, each with no more than
an eighth grade education, ensured that I was reading before I
entered kindergarten and I'll always have fond memories of sitting
with Mom or Dad reading Little Golden Books. Both instilled a
lifelong love of reading and my library is backlogged with books to
read after my fill of medical school books over the past three
years. I am thankful for my three sisters who put up with my antics
as we grew up and moved away from home. I am thankful for all of my
nieces and nephews, who carry on the family name and tradition of
gathering on Thanksgiving at my folks' home. That's a lot of people
in a 900-square-foot home, but the love expands the walls
immeasurably when everyone is present!
The Gathering Banquet Table: (L-R) Tim, Danielle, Jenna, and
I am thankful for each of my classmates. I have said that before
and I reiterate again today. The group of classmates I have are
individually wonderfully people. They are some of the finest, most
cooperative over-achievers one could meet. Regardless of the
challenge, this group comes together for each other, charitable
causes and communication. I am proud to be a part of the class of
December 2013 and have made life-long friendships during my times
I am thankful for my friends back home. We have been through
"thick and thin" together. Births, deaths, layoffs, downsizing,
promotions, marriage and divorce; each of my little group back home
is ever present to lend a hand, an ear, a shoulder or a back when
work needs to be done. These are the folks who didn't say I was
crazy for leaving a good job to become a naturopathic doc at 40
years old. These are the folks who ask every four months, "Are you
coming home Ammons?" Friends who want to catch up and are eager to
keep in touch are truly a thing to be thankful for.
I hope you are with the ones you care about this holiday. That
you have experienced a year of abundance in health, love and
happiness and that your dreams, plans and experiences have
contributed to your betterment and the betterment of all!
See you next week!
Today I reflect on my father and his positive impact upon my
life. My father is a man of few words; he lives by example. He has
always worked hard and continues to work in his early 80s in
addition to his gardening and work around the house.
Me as a toddler with my dad.
When the four of us (my three sisters and I) were growing up,
our dad was often working overtime at a furniture factory, where he
was a quality inspector. After working all day at the factory, we
would work well after dark with our crops for extra money to have a
nice Christmas holiday. Dad would allow us kids to play sports in
school or pursue other activities, other than that, we were to work
with him in the field. I think now that the "work unless you
participate in the community" rule was a way for us to become
involved, learn success as well as failure, and realize the
necessity of getting along with others.
When I was growing up as a youngster, I always felt safe with
Dad in the house. Some of my earliest memories are sitting on his
lap learning to read "Little Golden Books" well before entering
kindergarten. The amazing thing is that a man with an
8th grade education (as well as my Mom) saw the
immense value of learning to read…early. I remember Dad teaching me
about raising chickens, tending a garden, fixing up our old cars as
a teenager (not so much there, I was too stubborn to listen unless
I needed his help). Finally, the project that I will cherish for
the remainder of my life--the weekend that we built a bookcase
together in my late 20s.
The bookcase as it stands in my apartment now, full of medical
books and doo-dads!
I didn't realize the importance of that project at the time. I
never liked woodworking much and Dad and I weren't exactly close at
that point in our lives. No animosity, we are just both
strong-willed and somewhat stubborn men and each had our idea of
how to live as an adult. We spent the entire weekend working
cooperatively on the bookcase from only a hand-drawn sketch. No
griping, arguing over measurements, or creative disagreements--just
a vision and the beauty of the finished project--both the bookcase
project and our relationship as adults. I've never told Dad how
much that project meant, I reckon I will someday.
Dad's (and again Mom's) insistence that we kids learn to read
when we were just "young'uns" has stayed with my sisters and me.
For myself, I think the fun of reading with my Dad translated into
a passion for the written word and a thirst for learning that has
me here, at NUHS on my third career! Believe me, we get our share
of reading here!
Dad in his garden last year.
Now, as an older student at NUHS, I try to share the lessons
that my dad taught me, through example, by living as an expression
of his work ethic, sharing, patience, understanding, and guidance
where I can with my colleagues and friends. His lesson of
'leveling' the highs of success and lows of failure has been
perhaps the most applicable lesson while here in med
I am grateful for my father, his work ethic and insistence that
his children learn in areas he never did. I am grateful for my
father's appreciation of all human beings, creatures and kindness
toward others. I am grateful every day that I am the son of Roscoe
Ammons of Mars Hill, North Carolina.
• Combined Classes
• Observing in Clinic
• Botanical Medicine
• Minor Surgery
• Intern Skills
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