Updates from the Clinic - Back to School Strategies

Time for a Breath

Dr. Molly tells us that Anxiety is fear and avoidance. And right now it all seems unavoidable. And yet now is also the time to expand. To expand your breath. To expand your vision of what is and what can be. And by doing so prepare yourself for Fall and for children returning to school and many adults returning to work spaces. The foundation of your health remains the same and your concerns can be discussed with your naturopathic physician.

Below is good information from Dr. Hightower for families that have children returning to school

Back-to-School

By Dr. Kathryn Hightower

Back-to-school may look more three-dimensional this year! Most children are excited to see their friends in person every day. And many are also nervous about COVID.  It is more important than ever to think preventively about your child’s health, not only physically but mentally/emotionally as well.
Here are some reminders and suggestions:

Foundations of Health are like the soil where you plant the garden of your child’s health.
Hydration: 1/3 your child’s body weight in ounces.
Nutrition: eat the rainbow, eat regular meals.
Physical movement: daily.
Sleep: children need more sleep and at different times than adults, but schools often start very early. Think about helping your child gently transition into a school sleeping schedule now. Consider how you might seek change within your school or district to make start times match pediatric science!

Fill your own cup first as a parent.
What do you need daily to re-charge your battery?
Have you had your own annual wellness check this year?
Consider biofeedback, a personalized stress management program that Dr. Hightower offers at ECC.

Preventive stress management strategies teach long-term resilience.
Mindfulness, breath work, and other stress management strategies physiologically “re-wire” the nervous system to be more resilient in the face of stress.
These practices are best done twice per day when your child already feels relatively calm.
Fablefy is an awesome resource for mindfulness videos geared toward children.

Reminders
Masks are required at Emerald City Clinic
Austin Air Filters are 20% off

BLOOD DRAWS
Blood draws are $28 at Emerald City Clinic and payment is due at the time of service.  
Blood draws are scheduled for thirty minutes to allow for any difficulties with the draw and to allow the doctor time for processing - they are NOT scheduled to account for late arriving patients.  If you are more than 15 minutes late your doctor may chose to send you to a Labcorp or Quest facility.

Keep in Mind
Parking can be challenging at Emerald City Clinic.
Traffic is back to pre-pandemic levels.  Plan your travel accordingly.

IMTs on Wednesday, August 18th - 2:00 to 4:30 pm
September 6th - Closed for Labor Day

Notes from the Clinic - “Back to School” During a pandemic - Now What?

Notes From The Clinic 
Back to School
Dr. Kathryn Hightower

I have been tasked with writing this year’s “Back to School” blog. What a daunting task! In King County, it is still unclear what “back to school” will even look like. Across the country, debate rages on, especially in localities where schools are scheduled to open (or have already done so!).
I am aware of my privilege in saying that writing a blog is “daunting.” I have no one returning to school, so I can only imagine how daunting it is for you parents and caretakers out there. You who might be facing nine more months of homeschooling in the middle of a pandemic, while trying to maintain a work schedule or find a new job, navigate your little one wearing a mask in public, staying virtually connected with friends and family, etcetera, etcetera, etcetera!
Here are some suggestions for whole-family health during this time:

1.  Always start by re-evaluating Foundations of Health – eating healthy food, drinking plenty of water, moving your body daily, and sleeping restfully every night. Which of these areas needs the most work in your family’s life? 
          * Avoid judgment. Start by looking for one small change you can make to improve the health and well-being of your household. Some ideas: add veggies to your pizza, chose a fun new water bottle you'll be excited to drink from, read aloud a classic book with the whole family, make a walking chart to track your physical activities. Find ways to reward yourself and your family when you've accomplished these goals. Even adults need a gold star from time to time!

2.  Remember to fill your own cup first as a parent – what do you need daily to re-charge your battery? Even a few minutes of mindfulness meditation every day helps you re-balance your nervous system. See our blog from Stress Awareness Month for a 5-minute meditation practice.

3.  You can even practice mindfulness with your child. One great resource is Fablefy, with lots of great mindfulness training videos for children.  It is never too early or too late to learn self-regulating strategies to balance the nervous system.

4.  We at Emerald City Clinic are committed to primary care. We truly believe in the power of the Family Doctor, who can objectively and compassionately support the health of your family constellation. That means, we are open for annual check-ups for all ages. If your little one has not been seen for their yearly visit, now is the time to get scheduled – all pediatric appointments are 20% off this month.

5.  As you continue adventuring through the summer and transition into an unprecedented autumn, your family may encounter bumps, bruises, allergies, and illnesses. If you don’t already have a homeopathic first aid kit on hand, now is the time to pick one up. Kits are 20% off this month. Homeopathic remedies work especially well on little ones and can quickly clear up life’s bumps, bruises, and more.

Every child grows up in a constellation of adults and other children. Everyone in that constellation has health needs. This has never been more apparent than during this era.  We are here for your whole family.
 

Calendar
August 19th - IMT Scans from 8:30 to 4:00
September 7th - Clinic closed for Labor Day
September 23 - IMT Scans from 8:30 to noon

Stress Awareness and Frequently Asked Questions - blog from April 1, 2020

Frequently Asked Questions
STRESS AWARENESS

Dr. Kathryn Hightower - Notes from the Clinic

I don’t have to mention the name of the disease that has shut down the world in order to know that every single one of you reading this is stressed out. I will not relay any more dizzying data. Instead, I would like to offer a counterintuitive piece of stress management advice: don’t take deep breaths.

Okay, that’s an oversimplification. I do want you to take deep breaths - just not when you’re already stressed.

The way to start working on your breath is to practice when you are relatively calm already (and to not take “deep” breaths - stay tuned for a future blog about the components of a Functional Breath).

Here’s the gist: The goal of breath work is to increase resiliency in the face of stressors. More resilience means greater ability to absorb a stressful event and bounce back to yourself.

Now, if you only practice when you are already stressed out, your mind is going to associate the practice with stress. That is the exact opposite of what you are trying to do!

I cannot iterate that enough. You must practice when you are relatively calm.

Over time, you will notice yourself recalling the practice when you are NOT calm. All the sense memories from your calm practice will come flooding back to you and contribute to your sense of peace.

So, if you’re supposed to practice when you’re already calm, what if you’re never calm? I know everyone’s already taxed stress levels have been extremely heightened lately. You may feel like you’re never calm - so how can you ever practice? I did not say, “practice when you’re 100% the calmest you’ve ever been.” I said, “practice when you are relatively calm.”

Choose a time of day and a place in which you feel calmer than at other times. For some folks, that might mean first thing in the morning before your day gets started, or in the evening before bed. Regardless of when and where that is, choose that time and place and give it a try.

I recommend starting with 5 minutes per day, because that is doable for most of us. You’ll want to work your way up to 20 minutes twice per day - that amount of time has been shown in the research to confer the most physiological benefit.

Now, I am a biofeedback-trained practitioner and will be making another blog with more details. For now, just know I can individualize your daily practice to fit your particular way of dealing with stress. In the meantime, here is a practice that can confer benefit for most people: box breathing.

Find a comfortable seated position. Close your eyes or unfocus your gaze.

Inhale 4 counts.

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Hold 4 counts.

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Exhale 4 counts.

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Hold 4 counts.

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Repeat for 5 more minutes. End your practice by thanking yourself for taking this time.

Remember to practice when you are relatively calm and remember: we are all in this together.

Frequently Asked Questions 2

Good Information any time - Particularly in regards to COVID-19

What to do about a fever?

Here is an easy-to-read article about the physiology of fever: Fever Article

Fevers are your body’s way of cooking a pathogen to death. A fever is a good thing as long as you stay hydrated and do not "artificially.bake". You are well hydrated if your urination stays up to 6-8/day.

It is a normal immune response, regulated by the hypothalamus in your brain. The hypothalamus is constantly taking your temperature. If it is too low, your body will get signals telling it to shiver, which engages muscles and releases heat. If it is too high, you sweat. The coolest thing (no pun intended) about the hypothalamus is that it can also adjust your ideal body temperature to be higher – it raises the bar, so to speak. The reason you feel the “chills” when you have a fever, is because your hypothalamus has raised the bar – made your current ideal body temperature higher than usual - but your body hasn’t caught up to that new norm yet. You feel colder than usual, even though your temperature hasn’t changed or may even be warmer. Then, as your body works to elevate your temperature, you stop feeling chilled and probably start sweating – again, your body’s way of releasing heat because now you are extra hot!

Certain drugs, like ibuprofen and acetaminophen, stop a fever in its tracks by directly stopping fever signals to the hypothalamus. It will take a 2 day fever and make it a 4 day fever. Although fevers are uncomfortable we have many ways to make it more comfortable and therefore assist the body's natural defense mechanism. In fact, even the conventional medical community has begun to accept that fevers are helpful and normal. Fevers up to 101 degrees in an adult are safe and up to 103 degrees in children under 12 years old, we would like you to contact us in this pandemic if your temperature is 99 degrees. Also an important thing to realize is that our temperature is lowest in the morning and one degree higher in the evening, so a temperature of 99 degrees will be 100 at 5 pm. That is NOT an increase in temperature.

The traditional Wet Sock Treatment works with your body to help bring about a fever more quickly, so you can get over it more quickly. It also increases your parasympathetic nervous system – rest, digest, and heal. You can only heal in parasympathetic mode, and this will bring you there. It’s really easy. Warm your feet up in a bath of hot or warm water. Dry them off. Dip a pair of cotton socks in cold water. Wring them out. Put them on your feet. Put a layer of dry wool socks over that. Bundle up and go to bed. I know it initially sounds awful, but trust us: you will love it. It is so relaxing and again, it will help you mount a healthy fever.

Ask your Emerald City physician if you would like other tips for relieving discomfort in fever. And if your fever has gotten over 101, call the on-call phone so we can give you more urgent support.

What is one thing I can do for my immune system?

Our immune system depends on our white blood cells’ ability to respond. To make appropriate white blood cells, you need to stimulate your flat bones (e.g. sternum and hips), where they are made. This requires that you move. 8,000-10,000 steps a day will do that. The immune system also depends on the lymph system. Lymph is like the immune system’s freeways. The lymph system only moves with exercise (your muscles squeeze the lymph pathways, which lack their own muscles), gentle massage, and hydrotherapy (use of hot and cold). Finish your showers with a cold or cool rinse.

Notes From The Clinic - Virus, Venipunctures And Versatility

Virus

• Emerald City Clinic continues to take care of their patients by offering telemedicine  as well as in person appointments.

• Do not delay your health care due to COVID-19: continue to schedule regular blood draws and follow-ups with your doctor.

• For appointments at the clinic please call prior to coming in as we are monitoring physical distancing in our waiting room.  A mask covering your nose and mouth is required for entrance. 

• COVID-19 test and antibody (blood draw) testing is available and must be requested though your doctor at Emerald City Clinic.

• Support for those testing positive is available.

Venipunctures (Blood Draws)

• The majority of blood draws are fasting which means the following: 

  •     Fast for 12 hours prior to your draw

  •     Drink plenty of water the day before your draw and the day of your draw.(Hydrated veins are easier to access.)         

  •     Do not have coffee, tea, juice or food prior to your draw.

  •     Do not take your general supplements prior to your draw

    • (i.e. Multivitamin,  Vitamin C, Fish Oils, Vitamin D, etc.)

  •     Consult with your doctor via charm prior to your blood draw on other  supplements (i.e. Thyroid,)             

• Emerald City Clinic works primarily with two labs for blood draws:  Labcorp and Cleveland Heart Lab.   It is the responsibility of the patient to know their deductible and coverage.  Emerald City will assist you in the decision of which lab to use but will need to know  your deductible and coverage.  We primarily use Labcorp for insurance billing but for those with high deductibles we have the option of client pay with Cleveland Heart Lab and Labcorp where your costs are upfront and you pay between $300 and $400 for your labs.  

Versatility

Resiliency:  This is what is needed.
by Dr. Molly Niedermeryer

 
I have been in practice 36 years this summer and find now an opportune time to review our current national and global situation – naturopathically.  All my observations are through the lens of a naturopathic doctor and my 36 summers of naturopathic practice leave me clear on my response to the pandemic we are in and the social unrest due to systemic and oppressive racial injustice.   
First, I want my clients, staff, family and friends to recognize that we are only as healthy as the environment we inhabit.  We are all living globally in a world of high anxiety and fear.   My brilliant doctor daughter gave me this equation a few years ago:
 

Anxiety = Fear and Avoidance.
 

When we are anxious we drain our reserves and affect our overall health.  (And many have no reserves.) A quick way to reduce the anxiety is to have a “plan”, therefore you are not avoiding and you will feel better.  Information dispels fear but please be aware to not read too much as regurgitating the same information over and over is not helpful.    Make sure you feel safe, (physically, emotionally, and spiritually) and that is going to reduce anxiety.

 I look at these times as a healing crisis.  It is like the world’s forest fire with a cleansing and reshaping  of the world and of our personal environments.  And much like a forest fire we need a plan and a tool set to weather the firestorm.  

We need to recognize we will be living in this pandemic for at least a couple of years, so it is essential you settle into a healthy routine.  Health is defined as freedom from limitations and the least limiting is physical, then emotional and then spiritual. 
 

We should address all the planes of existence.
 

Physical:  Take care of yourself by following “Dr Molly’s 5 Point Health Plan”.  Wash your hands, and stay 6 feet away from people not in your bubble.  I feel the wearing of masks can be viewed as a spiritual practice of respecting other people by protecting them from you and reducing their anxiety.  It is a caring, considerate, easy, thoughtful and healthy way to operate in the world we find ourselves in.  In addition, under these circumstances of high anxiety can you do more for your adrenal glands?  Maybe there is an herbal formula that will nourish you and if you are comfortable doing so consider a massage or acupuncture treatment.

Feed yourself on all levels.

Emotional:  Stay connected; open your life up to your social circle safely and smartly.  Besides being present with each other physically we are fortunate to be living in a time where technology can bring you closer to family and friends with video calling or with texting.  Or you can go old school and write letters.  Explore new ways of communicating. Be creative in your connections:  zoom craft meet-up, watch a movie with a shared service, hulu hoop in the park, try geocaching, stream an opera and then talk about it.  Try to increase your safe bubble before it gets dark and dreary here in the northwest and we cannot meet outside anymore.  Learn something new and keep your brain supple.
 
Spiritual:  Wear your masks and protect others.  Remember to treat your neighbor as yourself.   Try each day to make the world a better place.  Practice being in the moment, and then the next moment…… What spiritual work or practice will feed you: journaling, meditation, prayer, art.  Do not dismiss the care of this part of yourself. 

Please remember that this too will pass and we will find ourselves in a better place after the cleansing and reshaping.   Humans are so brilliant and adaptable.  YOU ARE BRILLIANT AND ADAPTABLE.   I am learning how to prioritize, smell the roses, harvest the kale, practice yoga and be grateful.  Everyone at Emerald City Clinic is here to assist you with optimizing your health and keeping you safe. We care about you. 

Scheduling Appointments with Emerald City Clinic

COVID Update at Emerald City Clinic

Dr. Molly Niedermeyer will be scheduling more phone consultations than in person appointments. 
Dr. Paris Preston will continue with telemedicine and in person as needed. 
Dr. Kathryn Hightower and Dr. Stefanie LaSalle will continue to schedule telemedicine and also physical medicine per doctor request.
Blood draws are being scheduled.

Each doctor reviews the schedule to medically advise for the need for an in person appointment.  Patients can request in person appointments and we will try to honor those requests.  We understand the need for personal contact.

We are now scheduling Sauna appointments - which will be scheduled 2 hours apart.

Patient Protocol


Your temperature will be checked at the front door by staff prior to admittance.   

You must wear a mask at all times while in the clinic (except the sauna.) Please, please bring your own mask.

We prefer you have a credit card on file to pay for any appointments or supplements.  We strongly urge you to check prior to your appointment. 

If you are ordering supplements, we prefer you  send a request through the patient portal.  Once the order is fulfilled we will call you for pick up.  You must have a credit card on file or provide one at the time we call you.  We deliver your supplements to your car - in the back parking lot - and place it on the hood of your car.  This allows our staff to maintain social distancing. 

Additional Information

We will no longer have a water dispenser available in the lobby.  Please bring your own water bottle.

Our doctors and staff will continue to provide you with love and care and patience.  We ask that you do the same.

Our First Blog will be out soon!

Emerald City Naturopathic Clinic migrated it’s website on April 23, 2020. We will be posting blogs soon!

How To Get Your Child Ready To Go Back To School

School is starting and it is time to start getting your children ready. One of the best ways to get them ready is to start shifting bed time to align with when they’ll be getting up for school.  If you have not been doing routine supplements, then it’s time to get back on "Molly's 5 Point Health Plan" which includes good hydration, healthy diet, sleep and routine supplements.  In addition, please make sure you have appropriate immune support. This would be most beneficial by starting your children on something a couple days before and for the first few days while they adjust. Some examples of good immune support would be Thymactiv, extra vitamin C, or some of our new gummy products for the more taste oriented child.  Remember sleep, diet and water are the best immune support. As usual, always contact your doctor before drastically changing your child’s supplement regime.During the remaining days of August and the month of September, all supplements on our Calendar special shelf up front are 25% off. Take advantage of these fantastic discounts to stock up for the school year!In Health,Chelsea KernPharmacy Coordinator

Understanding Blood Work

The physicians at Emerald City Clinic examine all aspects of your life including what is flowing thru your body to design therapeutic plans to optimize your health.   The “normal ranges” of the lab results are based on the average American and our ranges are based on optimizing your health which may not necessarily fall within that range. Your blood is divided into two basic components:

1. Blood cells or Solids

•  Red blood cells that carry oxygen
• White blood cells which is your immune system
• Platelets that are there to help with clotting

2. Serum or Fluids:  This carries everything else we examine.The CBC or complete blood count is how we examine the solids.  We do counts of the red cells, white cells and platelets. 

1.  White blood cells are for our immune system.  They are our troops and should run between 5000-6000.   Besides the overall number, there are different types.  We should have 60% neutrophils (which are our swat team), 30% lymphocytes (which is our artillery), <10% monocytes (which fight virus), <5% eosinophils (which fight parasites and airborne allergies) and finally basophils which should be below <4% and our an inflammatory marker.
2. Red blood cells should be somewhere between  3.8 and 4.2 million cells.  They carry our oxygen and should be a certain size and shape which your physician also looks at.
3. Platelets should run around 250 and are responsible for proper clotting.

In the fluids of the blood, also called serum, we have a plethora of things we can examine.  There are entire books written on what can be found in your blood.  I will attempt to give an overview of categories:1.  Enzymes:  Every organ has its own enzymatic system.  If those enzymes are too high it usually indicates cell death in that organ.  If it is too low, it usually means the organ is under functioning and therefore has no recycling of the cell structure.  Under this category we have the following organ systems that we routinely look at:

• Kidneys:  BUN (blood urea nitrogen), Creatinine, GFR (glomular filtration rate)
• Liver:  AST, ALT
• Bones:  Alk phos

2.Individual chemicals: Items that are truly not enzymes

• Sodium/Potassium:  this is a reflection of adrenal function and neurological function since all the nerves run on sodium/potassium pumps
• Chloride/CO2:  tells us about the pH of the system and the digestive track
• Bilirubin:   fat digestion

3.  Inflammatory markers:  These are values we are looking for to rate overall inflammation in the body.

• CRP:   this is mostly cardiovascular but can be elevated due to other issues
• Uric acid:  marker for gout which is an arthritic condition
• Homocysteine:  vascular inflammation
• GTT:  liver inflammation
• Ferritin:  when high it is a general inflammatory marker
• Sed rate:  a measurement of red blood cell damage and therefore general inflammatory marker
• HgA1c:  hemoglobin A 1C:  average sugar level 24 hours/day for 3 months

4.  Cholesterol:   Many years ago we talked about “good” cholesterol (meaning HDLs) and “bad” cholesterol (meaning LDLs).  What we have found out is that there are many types of LDLs, HDLs. They are fragments that all have different roles.  The important thing about cholesterol is that an appropriate balance is needed because all our hormones, immune system,  nervous systems and skin, to name a few things are made from these building blocks.5. Hormones: There are the messengers of the body and travel from one location to another to direct our bodies.  Most hormones have a storage unit and a biological active version that is more potent and shorter acting.  Most hormones also are in a bound form when they travel around the body but most be “free” of their protein bound to influence the body.  Most often we want more of the storage version then active version so that our hormonal savings accounts are not depleted.  There are many more hormones than I will address but these are the most common we examine

• Thyroid
  • TSH (thyroid stimulating hormone) directs the thyroid to produce its hormone
  • T3:  short liver, biologically active hormone for about 6 hours
  • T4:   storage unit and is around for 12-14 hoursThe Female and Male hormones are found in both sexes and are needed in different amounts in both sexes.  One hormone is the transportation hormone for all sex hormones.  It is SHBG (sex hormone binding globulin).  If this hormone is too high then the hormone can NOT be delivered, the trucks are too sticky
• Female hormones:
  • FSH (follicle stimulating hormone) and LH (luteinizing hormones):  these direct the production of our eggs
  • Estrongens:  There are three versions of estrogens.
  • Estriol:  E3  shortest acting, biological active and most protective
  • Estradiol:  E2,  longer acting and also protective
  • Estrone:  E1, longest acting and most associated with hormone directed diseases
  • Progesterone:  highest in the second half of menstrual cycle and needs to be in balance with the estrogens
• Male hormones:
  • Testosterone:  comes in both a bound version (total testosterone) and unbound version (free testosterone)DHEA:   This hormone is a precursor to the estrogens and testosterone and support of the adrenal glands.  It too comes in bound version  (DHEA) and unbound version (DHEA –SO4).
• Vitamin D:  I am not sure whether to put this in immune system,  inflammatory marker or in hormones.  But I believe vitamin D acts like a hormone.
• Cortisol:   I leave this to last as this is the number one complaint of my clients.  I am tired.  Cortisol, also called, adrenaline is the measurement of our base energy.

I have put on our website my naturopathic normal for these values.  Remember the interpretation of labs is really an art and science and this just scratches the surface.  But the more we educate our clients the better they can manage their health and advocate for themselves.By Dr. Molly Niedermeyer 

Bringing Back the Castor Oil Pack

Castor oil has been used for thousands of years throughout many cultures.  Some reports show it being used as far back as 4000BC by the Greeks and India has a rich history of using it in their traditional ayurvedic medical practices.  Medicinally it has been most commonly used as a strong laxative but it has also been touted for its strong anti-inflammatory and analgesic action topically as well as its antimicrobial effect.  Surprisingly, the castor bean, if eaten whole, can be fatal due to a poisonous lectin component called ricin.  When the oil is pressed out of the bean, the toxic ricin is left behind so ingestion of the oil is not toxic, but its purgative (laxative) action is nothing to mess around with without the instruction of a health care professional.  The castor pack, on the other hand, is a different story.  The anti-inflammatory and analgesic effects of castor oil make it an easy at home treatment for many aches and pains.  Here’s a quick rundown of the best way to get relief from castor oil:

1. Smear the oil over the affected area.
2. Cover with old flannel that you’ve dedicated to the cause (castor oil stains are forever.)
3. Put a heat source over top of the flannel.
4. Lay back and relax for 30-60 minutes to let the heat drive the oil in.

Some of the most common topical uses of castor oil include muscle and joint aches and pains, gas and bloating, gall bladder colic, and menstrual cramps.  It can also be beneficial as a gentle detoxification when placed over the liver.  The liver is the main processing system of the body and helps to eliminate toxins from the blood, if the liver is congested (overloading leading to back up) it cannot do its job as effectively.  Castor oil packs over the liver help relieve this congestion so the body is better able to detox.  Castor oil is inexpensive (a little goes a long way) and available for purchase at most health food and supplement stores as well as here at Emerald City Clinic.  For more detailed instructions, check out our castor oil pack hand out here on our website ---> http://www.emeraldcityclinic.com/educational/pdfs/castor.pdfBy Jenna Jorgensen, ND

Providing Quality Care

Often patients question the need for follow up visits particularly in this day and age of easy online access to lab results that many clinics offer. We historically have not offered this service for a simple reason. We find that it does not generate quality patient care.There are many elements that go into a personal visit with our physicians that may not be immediately apparent. First of all, you are not “just another patient” to us. We strive to have a deep understanding of what has brought you to your current health state and what is needed to restore health and balance. So when we sit down with you to review labs we have a context that we are interpreting your labs from that is much broader than most providers offer as we look at the whole person. We are not just thinking of your health from the symptom that you presented with but all of you, body, mind and spirit.One of the principals of Naturopathic medicine is that of Docere, doctor as teacher. Teaching clients about their health and ways to improve it is core to our medicine. It has been our experience that when you sit with a client and review labs that understanding helps motivate clients to make changes. There is that “Ah ha” moment that allow the shift in behavior or lifestyle. The other benefit is that it often elicits further personal or family medical history that is important to overall care. So we will continue to advocate for that personal one to one relationship we have with clients.  Teaching clients and treating the whole person is our work and our passion.By Paris Preston, ND

Your Friendly Fever

I’ve written before about why fevers are a good thing.  As a reminder, they both stimulate our immune system and often slow down if not directly kill infectious organisms.  Fevers aren’t comfortable, but they are useful and even important.  In fact, before we had antibiotics that were effective against syphilis, syphilis patients were sometimes infected with malaria because the high fevers associated with malaria would kill syphilis and malaria was safer than syphilis!By suppressing a fever with aspirin or ibuprofen or Tylenol, you’re not allowing the body to go through the course of its normal immune response.  This also means that the immune system might not go through all the normal steps to effectively stop itself after the infection is clear.  The result can be a less efficient immune response or potentially even increased autoimmunity or allergies.  Our bodies have an incredible design.  Enzymes that perform different functions are temperature sensitive.  Most of our day to day enzymes function best around 98.6 degrees Fahrenheit.  Immune enzymes function better at higher temperatures.  Chronically low temperatures can mean chronically in-efficient enzyme function in almost every organ system.How we manage a fever can have profound implications for how quickly we recover from an acute illness as well as how our bodies deal with more chronic complaints.  I think of fever as a period of clearing and detoxification.  Physiologically, the body actually shuts down digestion during a fever and instead begins to break down muscle to use as fuel.  The liver becomes activated to process all of the breakdown and the immune molecules flowing through the body.Because digestion is shut down, eating during a fever can lead to increased toxicity and can push your body to process more than it should.  It can cause toxic undigested food to build up in the digestive tract, which can further stress the liver.  It can also pull essential resources away from fighting the infection and toward trying to deal with the food.  While hydration is vital during a fever, I do not recommend eating.Rather than eating, consider drinking water, nettle tea, other herbal teas, vegetable broth, or very dilute juice.  If energy is very low, you might drink something like coconut water, which will provide some glucose and great electrolytes without giving the body much to break down and process.  Typically, you’d want to fast and give complete rest until the fever has been gone for at least 24 hours.  When reintroducing foods, start with broths or blended vegetable soup for the first day and then return to solid foods following your appetite afterwards.There are a few dangers to fever.  A temperature that is too high can cause organ damage, but this typically won’t occur below 107 degrees Fahrenheit.  What is far more likely is dehydration since fluids evaporate so much faster from a hotter person.  Dehydration can then cause the person to run hotter than they otherwise would, because it’s harder for the body to cool itself naturally.  Febrile seizures can occur in children and the risk is higher in a dehydrated child.  While febrile seizures typically have no lasting side effects, they can be dangerous if they go on for a long time, if the child falls and hits his or her head.  They are also scary for parents to watch!Knowing what is normal and where the line of safety is when you haven’t navigated a fever this way can sometimes feel a little scary.  It’s a good idea to call your doctor and let them know what is going on so they can help you manage.  Your naturopath can help you assess if hydration is adequate or if the fever is getting too high.  We typically recommend that you call us before the fever hits a dangerous stage so we can reduce your anxiety and help you know how to keep the fever in a safe and useful range.  In an infant under 3 months, if the temp reaches 101 call right away.  For children 3 months to 13 years, call if the fever has been over 102 for more than 48 hours.  Adults don’t tend to spike fevers quite as high, so you may want to call with a temp over 101.5 for more than 48 hours.  Remember that fevers will often go up by a degree in the evening, so a relatively high fever in the morning can become an intense fever later in the day.  We’re always here to help you manage the fever safely, so even if you’re not sure about a lower fever, we’d prefer that you call than worry.   Naturopathic care also has many supportive measures that can help the fever feel less uncomfortable without suppressing it.  These include particular herbs, homeopathy, or use of hydrotherapy.By Erin Westaway, ND

What is visceral manipulation?

"Visceral manipulation" sounds mildly daunting, but in reality it is a gentle manual therapy technique that can be quite helpful to many people.  Viscera is fancy terminology for the internal organs such as the stomach, liver, intestines, lungs, heart, uterus, and bladder, so "visceral manipulation" is simply adjusting the location and movement of those organs so they can function optimally. Just like larger muscles, they can get "knots" or restrictions in their movements that inhibit optimal functioning.  Practitioners trained in visceral manipulation are trained to find where these restrictions are and to release them in a gentle manner so that the organs can return to a relaxed state. An example of a common restriction is a hiatal hernia in which a small portion of the stomach slips up into the esophagus, this commonly causes heartburn and reflux symptoms and is remedied by pulling the stomach back down using visceral manipulation techniques. Other common complaints that are good candidates for visceral manipulation include menstrual cramping, liver and gallbladder congestion, cramping of the diaphragm, constipation, diarrhea, nausea, gas/bloating, disbiosis, and asthma. What to check this therapy out for yourself?  Schedule a 30 minute Visceral Intro Session with Dr. Jenna Jorgensen, for $44 ($24 for Full Circle patients) at more than 50% discount!  Dr. Jenna has trained for 3 years in the technique of visceral manipulation along with other physical techniques that truly make her practice unique. 

What Is That You're Eating?

Many of my patients often tell me they feel confused about what to eat.  This is a complicated question based on the individual patient, but I have a couple of recommendations that are across the board and apply to just about everyone.

1. Eat a diet that is based on whole foods.  Technically a whole food is a food that isn’t processed and has no parts removed.  OK, so you’re going to chop and cook your food – that’s fine.  But eat food!  Start with as close to the whole food as possible and avoid packaged foods.  Shop around the perimeter of the grocery store.
2. Eat less sugar.  By sugar I mean anything containing sweeteners (sugar, agave, honey, brown rice syrup, maltodextrin, fructose, corn syrup, high fructose corn syrup, maltose, malt, fruit juice sweetener, evaporated cane juice, etc.)  Generally if you’re eating a whole foods diet, this will happen naturally.  Baking and sauces is where we tend to add sugar if we’re cooking at home, so watch out for this.  If you’re buying any premade food assume that it is sweetened unless you read the ingredients and see otherwise. This is true even if you’re at a restaurant and even if you’re shopping at the local natural foods co-op or Whole Foods.  When I ask my patients to really break the sugar habit, meaning I ask them to read ingredients on everything they consume, typically they are shocked by the amount of sugar in everything.  I cannot emphasize enough the degree to which sugar intake is implicated in almost every chronic illness on the rise in this country.  That list includes (and is not even remotely limited to): cancer, diabetes, heart disease, digestive complaints, hormonal imbalance, anxiety, insomnia, fatty liver disease, depression, and arthritis.
3. Stop eating chemicals!  Maybe you’re thinking:  “I’m reading a blog by a naturopath about what to eat; of course I wouldn’t eat chemicals!”  Maybe that’s true.  Take this challenge: go home and look in your pantry.  Pull out anything that has an ingredient that you don’t really know what it means.   This includes the statement “natural flavors” and “artificial flavors”.  Ever wondered what those terms mean?  So do I.  Unfortunately they are so vague, I can’t even tell you.  What I can tell you is that a typical flavor includes around 100 ingredients and about 80-90% of those ingredients are synthetic chemicals that companies are not required to report.  One known ingredient even in “natural flavors” is propylene glycol, which is no longer allowed in pet food due to the fact that it causes anemia in cats.  I think I’d rather leave it out of my food as well.  The fact is that we really don’t know what a lot of food additives and preservatives do.  We often discover later that some of them contribute to cancer and other illnesses.  My general rule is stick with eating things that humans have been eating safely for thousands of years and avoid chemicals and additives with unknown or harmful impacts on the body.

What is in your supplements?

Every few months we hear reports in the media of supplements that either don’t contain what they say they do or are contaminated by toxins.  We do sell supplements in our office and use them regularly with patients.  We choose the companies we work with because of their quality.  The companies we use test each batch of raw material for purity and each batch of finished product to make sure that it contains what it’s supposed to and nothing else.  Our fish oils, for example, are tested to make sure that they do not contain dangerous levels of mercury.  We avoid products that contain unnecessary dyes and chemical preservatives whenever possible.Because the supplements that we recommend are of high quality and there is a lot of testing that goes into the manufacturing process, they are often more costly than other brands.  Often my patients want to save money and buy a different brand or buy something they can find more easily.  While I understand this desire, I always try and steer them back to the companies I trust.  The latest article on this issue from The New York Times (http://well.blogs.nytimes.com/2015/02/03/sidebar-whats-in-those-supplements/) refers to some testing on products from some of those cheaper brands.  It turns out that many of the products contained absolutely none of what was supposed to be the main ingredient.  What I try to explain to my patients is that buying these other brands may mean throwing your money away.  You won’t get the results that you’re looking for and it could impact your health in ways that you don’t want.If my patients prefer not to buy their supplements directly from the office, I have no problem with that.  Many high quality brands can be purchased at places like Pharmaca, which sell physician quality supplements.  What I do care about is that my patients get what they think they are buying and take supplements that are safe.  Often my patients have researched on the internet and found a supplement that is supposedly useful in their condition.  I will always look at the supplement with them and sometimes the ingredients in the product do seem to make sense for that patient.  Even so, I’m not familiar with the quality of every brand out there.  In those cases I usually tell them that the product could potentially be helpful, but I can’t speak to the quality or purity of ingredients.  I will continue to recommend brands that I’m familiar with, brands that I know do regular quality and purity assessments of their products, brands where I have seen good results with my patients.By Dr. Erin Westaway, ND 

Measles Vaccine Scare

I have been getting lots of emails and questions about whether my clients made good decision not to immunize their children and rather to reconsider their decision in the light of the Disney measles outbreak.  I support you in re-examining your decisions but my medical advise generally speaking is that the risk of live vaccines, with preservatives and chemicals in them, outweigh the risk of the possibility of catching the disease.  A healthy immune system is designed to withstand these immunological insults and actually have been designed to be stimulated an improved by these child hood diseases if caught at a young age.  Minimally, a good immune system is the best defense against any illness along with frequent hand washing.This media frenzy and medical scare tactics are convenient for the dominant medical model to continue to pressure families into immunization decisions.  It is true that of all the childhood diseases we immunize for, the measles is one of the riskiest diseases to get.  Unfortunately, there is no way to get the measles vaccine solo without the others as well. Opening up a conversation individually about your choices,  your children's individual health and immune status is legitimate but should not be done over emails if you have concerns.  The best approach is to analyze individual risks and benefits of either immunizing or not as well as some of the alternative energetic approaches we can also engage in once you make an appointment with your Emerald City Clinic physician.By Dr. Molly Niedermeyer, ND

Bone Broth to Keep you Healthy During the Winter!

Despite Seattle’s recent mild weather we are still in the winter season, which in many traditions is the ideal time for nourishing the body through diet. One of the simplest ways to do this is with bone broth. Bone broth has been prepared in cultures across the globe for centuries both in times of sickness (i.e. chicken noodle soup), and in health (supports hair, skin, bones, nails. GI tract, tendons, etc). Bone broth has gained a lot of attention recently as a new fad food with shops similar to coffee shops serving bone broth in New York. Bone broth is easy to make, tastes yummy, good on its own or used as a base for other cooking. See the Emerald City website’s handouts section for yummy bone broth ideas and recipes.

By Dr. Chad Borys, ND, LAc

How to Create Healthy Habits

In 2009, a study in the European Journal of Social Psycology, found that the average number of days it takes to incorporate a new habit into a daily routine is 66.  As I write, we are 12 days into the month of January, the most popular time for people to be challenging new habits.  In case you are needing some inspiration to keep working on a new healthy habit, go ahead and put a gold star on the calendar for Monday March 9th as this will be 66 days from January 1st.  Be persistent until then and you may just have yourself a new healthy habit!By Dr. Jenna Jorgensen, ND

Winter's Storage: A Chinese Medicine Perspective

As many of you know I grew up in Colorado, where even on the coldest, snowiest winter days you can still expect some sunshine. Needless to say, the adjustment to Seattle’s winters always comes as a shock to me. Seattle, with its two hundred plus cloudy days yearly, can be a challenging environment especially in the winter, with our long nights and short rainy days. However, Seattle is also the perfect environment to embody the spirit of winter and nourish your body and spirit.              From a Chinese medicine perspective, the seasons are a beacon for directing our daily lives; they inform us what to eat and how to live throughout the year to maintain health. Humans and nature are intimately intertwined and this relationship directs us not only in maintaining our health and preventing illness, but also into cultivating our inner mindset and character. In Chinese medicine, winter is the season of the kidneys, which is the organ of our root essence and constitution. It directs who we are, how we think, our immune system, and ultimately how we age and develop. In many respects the kidneys are the principle organ we need to protect and nourish throughout our lives. To start nourishing your kidneys this winter, I have outlined some tips below:

1. Rest: During winter, the cold drives our qi/energy deeper in order to conserve and store energy for the upcoming year. It is the time of year that we need to go to bed earlier and sleep in later. Seattle’s winters are perfect for this, as our lighting provides lots of natural cues for enabling plenty of sleep. Exhaustion at this time of year is more harmful than during any other season, and can impair the ability to fully function and be healthy the following summer. From a Chinese Medicine perspective, exhaustion at this time of year is a sign that you may have overdone it during the summer months, and now your body is having to work harder to recuperate the lost energy.
2. Inner reflection: Winter is the time to reflect and deepen our sense of self. It is the time of the year that we look inward and start to reintegrate our experiences and learnings from the past year. Consider starting a journal or cultivating a meditation practice as ways to promote inner reflection, and avoid turning on the television.
3. Pursue creative outlets: Find ways to prevent “cabin fever.” Read books and day dream, write poetry, paint, take dance lessons…the opportunities are endless in Seattle. As opposed to the summer when “yang” or the active energy in our lives peaks, winter is the peak time for “yin” energy, which is the imaginative and nursing aspect of our being. This is the time to let go of linear rigid ways of being and to invent or rediscover new possibilities.
4. Exercise daily: While rest is essential in the winter, we also need to guard against lethargy and stagnate energy with daily exercise. Consider looking on livingsocial.com or groupon.com for deals on exercise classes.
5. Diet: In the winter, cold air drives the body’s heat inward and food should be taken to support this. Spices likes cardamom, ginger, garlic, cumin, and cinnamon all help to support digestion and maintain body heat. On the other hand spicy foods, like curries and salsas, tend to be eaten in warmer climates to bring heat to the surface by inducing us to sweat and should be avoided. We also need to avoid cold foods (iced drinks, raw foods, salads, dairy, soy milk, juices), as they impair the digestive fires and create coldness in the body. A poor diet in winter creates extra work for the body by diverting energy to maintain the body’s warmth and ultimately can make us more susceptible to illness in the coming year. Think of thanksgiving dinner with its many warming foods (turkey, yams, stuffing, hot apple cider, etc); everything is cooked and spiced to help support the winter season. Also, consider salting food to taste and adding foods with higher mineral content to meals (seaweed, nettles), as salt is the flavor of winter and nourishes the adrenal glands.
6. Dress warmly: Cover the back of your neck with a scarf, and wear a hat and warm socks.

By Dr. Chad Borys, ND, LAc

Naturopathic Doctors 101

“You’re a Na-tur-ro…what?”  This is not an uncommon phase to be heard by a Naturopathic Physician, even here in Seattle where there is a good concentration of Naturopathic Doctors (NDs). Even patients of NDs are often unaware of the plethora of therapies and services NDs are trained in.  Naturopathic Doctors attend one of 5 accredited universities in the United States, the two largest being Bastyr University in Seattle, WA and the National College of Natural Medicine in Portland, OR.  These doctorate level programs are a minimum of 4 years long with a competitive option for another 1-3 years of residency. Naturopathic medical school curriculum contains the same basic sciences of conventional medical school (anatomy, physiology, biochemistry, pathology, pharmacology, etc…) as well as additional classes in naturopathic-specific therapies.  Examples of these Naturopathic-specific therapies include: nutritional therapies, counseling, botanical medicine, homeopathy, and physical medicine.  This education prepares graduates of accredited programs to enter the medical profession as primary care physicians after passing the Naturopathic licensing board exams (NPLEX).   There are 17 states (and counting) that provide licensure for NDs currently in the United States.  Each of those states governs a different scope of practice for NDs practicing within their state lines.  For example, the state of Washington has a rather comprehensive scope of practice, NDs are licensed as primary care providers with prescribing rights for the majority of common pharmaceuticals and have coverage by most insurances in the state.  So how does a Naturopathic Doctor practice?Naturopathic doctors follow the same general model as Medical doctors, with extra assessments and therapies incorporated.  The process looks something like this:

1. Obtain a detailed history of the patient’s current and past medical issues.
2. Perform appropriate physical exam to aid in diagnosis
3. Order any necessary labs or imaging
4. Determine biomedical assessment and Naturopathic assessment
5. Decide upon proper Naturopathic and conventional treatment options for the individual patient.
6. Provide efficient follow up

Some special considerations that NDs add to medical assessment include:

• General Lifestyle (diet, hydration, exercise, sleep)
• Nutritional stress
• Chemical and environmental stress
• Elimination channels and detoxification processes
• Hormonal stress
• Mental, emotional, and spiritual health
• Structural stress

What does this look like at Emerald City Clinic?Emerald City Clinic is a shining example of a Naturopathic primary care practice.  Our services include:

• Annual exams (both male and female)
• Chronic disease management
• Acute disease management (for established patients)
• Minor surgical procedures (wart removal, skin tag removal, cervical dysplasia treatments)
• Well child exams
• Pediatric care
• Prenatal care
• Standard laboratory assessment
• IV therapies (nutritional and rehydration)
• Acupuncture
• Manual therapies such as Naturopathic manipulations, craniosacral, and visceral manipulation
• PIP claims (for established patients)
• Biofeedback and counseling
• Weight management
• Stress management
• Detoxification therapies and environmental medicine
• Heavy metal toxicity assessment and management
• Immune system assessment and autoimmune management
• Digestive health assessment and management

While this provides a good idea of what our physicians can address, the best way to find out how we can help you specifically, is to come in for a visit. Also, be sure to keep us in mind when you’re making your New Year’s resolutions, here are some ideas for how our physicians can assist you in the New Year:

• Support and direction in your weight management goals: why are those extra pounds sticking around for you, specifically?
• Baseline health assessments: when was the last time you had routine bloodwork and a physical exam?
• Nutritional counseling: how to eat healthy in the New Year and prepare for spring detox.
• Elimination diet and anti-inflammatory diet guidance: what food sensitivities are causing inflammation in your body?
• Manual therapy: Are aches and pains preventing you from starting on a regular exercise regime?

By Dr. Jenna Jorgensen, ND

Holiday Stress Relievers

Stress is neither good nor bad, it just is.   The stress we put on our bones allows them to remain strong.  Emotional stress allows us to learn adaptive strategies.  Often it is our attitudes and ability to “let go” that mitigate any resulting harmful effects. When we are stressed it causes our cortisol or adrenaline to rise.  This in turns causes vasoconstriction of the peripheral blood system so that all the blood on the “outside” of our bodies goes to the deep places such as the survival part of the brain, the heart and lungs, and the quads and gluts so we can run from danger.  In turn the reduced blood flow to the periphery causes a myriad of symptoms including short term memory loss, alopecia or loss of hair, headaches, blurred vision, temperature regulation problems, and digestive problems; just to name a few.Stress also causes insomnia as we are not supposed to sleep through danger.  Eventually we wear out and end up with depression, hypoglycemia, and lack of motivation.  So, how to minimize the effects of stress? Here are some “simple” things you can do:Physically you must keep your sugar levels stable.  This means eat protein every 3-4 hours and have plenty of vegetables.   Stay hydrated so your blood vessels are relaxed.Walk it off whenever you start to feel overwhelmed; step away from the stress and go outside.   There are therapists that have couples wear pulse meters and when their heart rate gets over 100 beats per minute (bpm) in some upsetting situation they terminate the session and have people “walk it off.”  The reason for this is that when your heart rate is over 100 bpm, then your cerebral cortex, where we process logically, is NOT functioning and you are in your limbic system, which is all emotional survival.  Not a good place to think critically.  So it is important to “walk it off” and leave the stressful situation until you have calmed yourself.  Aerobic exercise with concurrent sweating also helps metabolize stress hormones.  If you exercise regularly you have prepared your blood vessels to handle emotional stressors. An exercise routine is a good investment in managing stress in addition to all the other health benefits found in exercise.Sleep helps with stress, but 65% of all Americans lose sleep over stress.  It is a viscous cycle because a lack of sleep raises stress hormones, which in turn raise blood pressure and blood sugar.  Some simple things to try are having a bedtime routine (good sleep hygiene), no TV or computer screens but instead dim lighting, soft music, reading.  The bedroom should be cool, dark, quiet and comfortable. If you have trouble sleeping for more than 3 nights in a row it is time to consult your Emerald City Clinic physician.Do not add fuel to the stressful fire.  Unhealthy habits such as alcohol, sugar, caffeine, cigarettes and overeating add to the overall stress to the body.Spend time with happy people as it really fills us with oxytocin, a hormone that relaxes us.   Laughter and hugs relax us and relax our blood vessels lowering blood pressure and stress hormones.Make choices that do not feel like obligations and “should” but spend time with people that improve your feeling of self worth.    Recently I spent time with my daughter, Brittany who is in her PhD program for Counseling, Psychology.  She and I were discussing that she prefers the wellness model for mental health; much like a Naturopathic perspective of focusing on optimal health.  With that in mind she had me take a test that focuses on your emotional strengths.  I would like to share that website.  It is www.viacharacter.org and you can register for free, after you fill it in you can watch the YouTube piece on “strength of character” that explains your outcome.  I think during this holiday season we should focus on what we do well and share it.  Wishing you all a peaceful, love-filled holiday season.Dr. Molly Niedermeyer, ND