One of the many skills that we develop while here at NUHS, and
perhaps one of the more important, is taking an assessment of a
patient's typical diet. Once we have a good diet recall or diary
from a patient, we can determine the benefits and drawbacks of the
patient's diet, the impact (for better or worse) upon the patient's
health, and then we can make modifications as necessary to help the
patient return to a basis for health.
Intern Heather Bautista taking a dietary assessment from
Intern Jerrica Sweetnich.
We start by getting a log of a patient's typical weekday and
weekend diets as many people eat differently on the weekends than
they do during the workweek. After a review of the diet with the
patient, we consult with our clinicians regarding the patient's
chief complaint, review of systems, health stressors, and treatment
plan. Part of the treatment plan involves modifications in a
patient's diet and may include the following:
...just to name a few.
Dietary modifications are a key tool to help our patients return
to a basis for health. Our health begins with the nutrients we
provide our bodies for building strong muscle, bone, nervous
tissue, and preventing or fighting infection.
With that said, I'll grab a healthy bite to eat and make my way
to clinic for the afternoon shift. This evening its time to carve
pumpkins by the fire pit and make ready for Halloween!
This past week was spent finishing and polishing my presentation
for Grand Rounds titled "Safely managing prehypertension and stage
1 hypertension with botanicals." This is a subject that is close to
my heart if you will since hypertension and strokes are a common
occurrence on my father's side of the family.
Hypertension has been called the "silent killer" as a patient
may not notice any symptoms until a significant medical event such
as a stroke or heart attack occurs. A skilled, thorough doctor
performing a routine general physical exam can sometimes uncover
masked symptoms, which a patient may not even be cognizant about. A
well-performed physical exam can help prevent illness or even
prevent an early death.
At NUHS, we are trained on basic physical exam skills beginning
in our second of 10 trimesters. We are taught to fully examine the
patient through observation, listening, touch, and measurement. As
we progress through the curriculum, we build upon our basic
skillset and learn to interpret what we discover. This
interpretation is honed under the guidance of our clinicians in the
Whole Health Center and satellite offices.
A quick rundown of some of our exam procedures includes:
This seems like a lot to do in one visit, especially if the
patient is in a hurry. We have the physical exam presented so
often, that by the time we are in clinic, we can perform this exam
in 30 minutes or less! This gives plenty of time for the remainder
of the patient visit and conversation. The general physical exam is
intended as a screening tool to determine if more focused
examinations are required for the patient. The physical exam
skillset we learn at NUHS helps us to target key systems with
quick, accurate examinations. When in practice as primary care
doctors, we will rely on this skillset each day with our future
patients. These skills will help us save lives.
This past weekend, Lauren and I went on a pumpkin search at a
local farm here in Illinois. After a nice (yet not so healthy)
snack of freshly made apple cider donuts and local fresh apple
cider, we embarked on our journey through the corn maze to the
secret pumpkin patch where we continued our hunt for the perfect
pumpkin! As the day progressed and the sun shined in all its glory,
we realized we needed some water, so we paused the great pumpkin
hunt to stock up and refill with some high quality H20!
Who knew that we would need to rehydrate on a little pumpkin
search!? I guess that keeping hydrated is key to finding a great
pumpkin. So, after filling up on water, we continued on our quest
only to find pumpkin fudge instead! I guess supplementing with
water doesn't help with finding the perfect pumpkin, but pumpkin
fudge (in moderation) is a nice treat!
This leads me to supplementation, another skill that is built
and added to our doctor's toolkit here at NUHS. According to the
Oxford dictionary, in general terms, to supplement is to enhance or
complete something where a deficiency exists. In naturopathic
terms, administering supplements acts in the very same way for
Supplementation can include a simple saline solution, water or
electrolytes for someone who is dehydrated (on a pumpkin hunt),
vitamins, amino acids or a combination of any of the building
blocks, enzymes, cofactors...well, you get the idea...for any
deficiency in a human being.
Just a few of the conditions that we treat with supplementation
Our supplementation training begins very early in our
biochemistry classes with Dr. McRae, through our clinical
experience training with simulated patients and practice cases
until we reach the naturopathic clinic as interns. We learn the
various methods of administering a supplement to achieve the
greatest efficacy from the dose, whether orally, topically, or
Through the appropriate use of supplementation, we can help our
patients correct imbalances while incorporating and restoring the
basic determinants for healthy living. Ideally, once our patients
are returned to a basis for health, we will no longer need to
supplement as their diet, lifestyle and habits can help them
maintain a healthy state of living. For those who need
supplementation, a properly trained naturopathic intern and doctor
can provide the proper supplementation at the proper dose to help
our patients be their healthiest!
The autumn finally settled in here in Illinois this past week
with crisp mornings and warm days. The trees have shifted in color
just a bit on their topmost branches and I expect that we will see
the full blossoming of autumn in the next two or three weeks.
This week I'll talk a bit about botanical medicine and our
skillset that is developed both in our botanical medicine courses
as well as in clinical practice. Botanicals are powerful tools in
the naturopathic doctor's toolbox; proper instruction, use and
avoidance are necessary to effectively help others with this form
of our eclectic approach to medicine.
LaKisha Brandon (9th Tri), Darius Lembert (10th Tri), and
Joclyn Davis (9th Tri)
formulating and dispensing a custom tincture from our clinic
My definition of botanical medicine is using plants and their
constituent chemicals to help others heal. To that end we have a
series of four botanical medicine courses before and during our
clinical rotations here at NUHS to prepare us as new practitioners
out in practice.
Dr. Lorinda Sorensen and Dr. Fraser Smith (Dean of Naturopathic
Medicine) guide our ND students skillfully through this course
sequence in a way that prepares our future docs with a wealth of
information. We study the habitat, harvesting methods, parts of the
plants that are used, and proper preparation from harvest to
medicine. We are taught interactions (both beneficial and
dangerous) with pharmaceutical drugs. Finally, we learn the proper
times to use and avoid any botanical medicine, as well as the
proper dosage method, amount and timing.
When in clinic, we custom prepare our own tinctures based upon
the needs of the patient. We utilize the variety of professionally
prepared, medicinal grade botanical preparations at our disposal in
the clinic dispensary. We combine our botanical medicines with
other therapies that can help our patients on the path to a return
to their basis of health. This could be a quick turnaround or could
take some time depending upon the pathology and methodologies
utilized in the treatment plan. Through learning botanical medicine
at NUHS, I feel that we are well prepared to enter our practices
with a solid botanical skillset.
This week, I'll take a look at another of the skills that
Naturopathic Interns need to master prior to graduation:
Hydrotherapy treatments that we perform with the patients in our
clinic as well as training patients for hydrotherapy they can do at
Some of the reasons that people would visit our clinic for
As we sit with each patient, gather the symptom picture,
understand all facets of the patient's case, and work toward the
center of gravity (or root cause) of the patient's complaint, we
work with our clinicians to establish the best treatment strategy
for our patients. Sometimes, this treatment plan includes a form of
After determining if hydrotherapy is appropriate and beneficial
for our patient, we refer the patient to our hydrotherapy shift,
which consists of our 7th trimester ND students. This is one of the
best aspects of our program here at NUHS. Our students are not only
being exposed to the clinic environment, but they are working in
clinic under the direct supervision of a clinician as an observer
at the halfway point in their education here, getting practical
experience outside the classroom. That aside, we refer the patient
with treatment plan to the hydro shift where "in office"
hydrotherapy treatments such as these are performed.
Dr. Kristina Conner - ND Faculty
Finally, the high quality of hydrotherapy care here at NUHS is
the direct result of the skill and knowledge shared by Dr. Kristina
Conner, who teaches our hydrotherapy classes in the tradition of
Father Kneipp and Dr. Henry Lindlahr, both pioneers of naturopathic
medicine. Dr. Conner has perhaps the most thorough labs that I have
experienced here at NUHS. We are immediately thrust into
treatment in a lab setting, learning the skills that are necessary
for accurate diagnosis and application of hydrotherapy treatments.
As a result, when we start performing hydrotherapy treatments in
the clinic, we are prepared for our patients. Hydrotherapy, a
powerful treatment option, is one of the more solid skillsets I
will take with me from NUHS.
I will cover more of our naturopathic intern skillsets in the
coming weeks. Until then, I'll be by Janse pond.
• Combined Classes
• Observing in Clinic
• Botanical Medicine
• Minor Surgery
• Intern Skills
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