Archive for tag: family

Time for Graduation

In just a few days, after more than four years, I will walk across the stage, accept the Doctor of Naturopathic Medicine degree and begin the next stage of my journey. This week I thought I might write a long retrospective on my time here, or perhaps list a lot of names of friends, colleagues and mentors. Instead, in the spirit of what this blog for the naturopathic program is supposed to convey, I will write a bit more about the program as I sign off and hand the torch to the next blogger.

Being a Naturopathic Student at NUHS

As with any institution, relationship, job or task, the naturopathic program here at NUHS has attributes where it excels as well as challenges. In many cases, those challenges help the program to rise in other areas. One prime example is that we attend a traditional chiropractic university. This means we may not immediately be perceived as a bastion of naturopathic medicine and we get a lot of physical medicine in our classes. I used to complain about this as much as any other naturopathic student. We are becoming primary care and internal medicine docs, so why would we need all this adjusting, physical therapy, soft tissue work, etc.

After more than a year in the clinic, I am happy that we were trained so heavily in physical medicine. Many of my patients benefited from some type of soft tissue work, physical therapy or modality. I attribute the combined use of all tools in my naturopathic toolbox to helping many of my patients achieve positive outcomes.

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Whether physical medicine will remain a part of National University's naturopathic program remains to be seen. As our scope is defined and made into law in Illinois in the coming years, combined with the maturation, refinement and focus of our particular school's curriculum, we may emerge as a naturopathic program focused on the original vision and philosophy of naturopathic medicine as the old naturopathic doctors saw it. I am certain our program will combine that wealth of traditional medicine with the advantage of evidence-based medicine to support the clinical observations of nearly 150 years of North American naturopathic practice.

Many who email me ask what to expect here at NUHS. I say expect what you see in any organization. Those who are highly motivated to learn everything they can, those who are trying very hard and struggling, those who will skate by until they enter clinic and slam head first into a brick wall, flounder, then either learn to perform or wash out. Students who enter here will be amazed, inspired, challenged, dejected, angered, overjoyed and feel an incredible sense of accomplishment. You will be challenged by those in the allopathic community on how your medicine can work alongside their medicine (or even work). You will be ignored by family and friends who see you as their child, sibling, friend, and anything but an aspiring doctor. You will feel overwhelmed at times knowing that you are in a program every bit as (and more) challenging than allopathic medical school with as much or more cost involved, and all the while able to practice currently with a recognized scope in less than half of the United States of America.

At the same time, you are learning a type of medicine that truly follows the naturopathic principle of Primum Non Nocere or "First, do no harm." We learn to take the totality of the patient - mind, body and soul - into account. We get to the root cause of the illness and work with our patients (and other providers) to help them return to their basis for health. We learn that healthy means different things to different people and that the basis for health is a moving target as human beings encounter different circumstances, health challenges and ages throughout a lifetime. Whether this is primary lesson learned by others while here, this view that none of us "fit into a defined parameter" is the view I will carry forward in my future practice. Each patient is unique, with a unique set of symptoms, life experiences and exposures that define that unique individual and their resulting unique path back to health.

I purposely have not been using much medical terminology as I have written this blog as, quite frankly, I feel that gets boring for those who want to know what this medicine and school are all about. When you attend NUHS, you will get your fill of CBCs, CMPs, URTIs, ARDS, ECGs, TVUS, MTHFRs and HSCRPs. These terms have their place in the classroom, not in a blog discussing life in a medical school unless as a passing reference. My hope has been that I have given a glimpse into the life of a naturopathic medical student transitioning from basic didactics to clinical sciences and finally through internship and graduation.

Thank You...

Finally, since I have shared my life for the past two years, I'll be a bit selfish and will thank some folks who have made strong, positive influences on my life.

My parents Rosco and Bobbie Joe Ammons - two people who have 8th grade educations and taught me to read before kindergarten and instilled the strong value of always educating oneself regardless of career choice. More so, for teaching me honesty, giving others credit for success and accepting failure as a motivator to persevere. I love you both!

My sisters Kristie, Karen and Kathy - for being the glue holding the family together back home as I continue my wandering through life and the eastern half of the North American continent.

My great friend Richard - who has shared his loyalty through both good and terrible times. You are a symbol of the power of true friendship!

My former wife Sara - Thank you for a shared journey of learning, growing and opening my eyes to living a healthier life, in many ways. You are the catalyst for this endeavor.

Ignacio and Christina - Thank you for being incredible mentors, both philosophical as well as practical. Your patience is extraordinary and your ability to put things into perspective on both a micro and macro level is a gift I cherish!

NUHS' Chief Naturopathic Clinician, Dr. Julia Liebich - Thank you for leading by example, keeping the clinic a positive, cheerful learning environment during a time of transition in our lives. You always ensure that we have our patients' best interests and health as the focus of our care and procedures!

Finally, my very significant other, Lauren. Thank you for teaching me that who we want in our life is not necessarily the person we expect and that each day in a relationship can be more joyful, playful and rewarding than before! You make me smile and I'm grateful for the time we have together!

With that, I begin my particular path forward. I plan to continue a blog as I set up and build momentum in my practice after school. I'm sure you will be able to "google" me if you are interested in continuing to read my ramblings. I wish you the best on your own journey, whether it includes NUHS or not. You know the correct path for yourself! May your journey be safe, fulfilled and successful in whatever you choose and may it bring goodness and healing to the world in its own way!

High Force Intervention

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 medications.

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.

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My sister Kristie, Ladybug and Mom earlier this summer.

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!

New Classes

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.

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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.

Thanksgiving

Hi Everyone!

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 Thanksgiving.

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!

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The Gathering Banquet Table: (L-R) Tim, Danielle, Jenna, and Fatemeh

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 at NUHS.

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!

Father's Day and a Bookcase

Hi Everyone!

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.

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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. 

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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!

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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 school. 

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.