Taking care of yourself (Yoga, exercise, the clinic)

   Today was day two of the Yogathon that the NMSA (naturopathic medical student association) is running this week. This marathon involves Yoga from 7:30-8:30am every morning of this week. Though you don't have to do it all, I decided to challenge myself and do it, along with support from a couple friends who are also doing it. It's relaxing and really good for you (especially all the stretching is good for my chronic neck problems), and not to mention there's a prize draw for anyone who goes to all 5 days. Since I'm talking about this, I want to quickly share the nonprofit charity one of the yoga teachers is part of called Share The Love Yoga. You can read about it, but it's a pretty cool organization focused on providing affordable and accessible yoga, which we know is an amazing form of exercise, meditation and just great for taking care of yourself in general.

Savasana, my favourite yoga pose because it is pure relaxation (not to mention final savasana means the hard work is over!)

                       
   After Homeopathy today (another loaded class --> learned about posology and miasms today, as well as going over a case we did in class), I had my usual clinic appointment (I go almost every Tuesday). It has been really great going to the clinic so often while here. It's something I never really did before, but it's great to have this opportunity to take care of myself and keep on checking in on how I am doing. Not to mention it is a useful opportunity to get more time observing what naturopathic care is like but from the patient point of view. Anyway today was interesting because we actually did more of a homeopathic intake (most of my treatment has been acupuncture, massage and spinal manipulations for the neck pain). It was very different to what I'm used to, but I'm interested in seeing where it goes with my intern finding a good remedy for me. It was also a nice experience just talking about a lot of random stuff. It was very relaxing in a different way, and felt good to express myself in a completely non-judgemental and safe environment. I also ended up having a little bit of acupuncture. Today was interesting because it was the first time I wasn't on my back on the treatment table (I was sitting in a chair just answering questions), so I actually saw the needles for the first time. They aren't really that scary or anything, and don't really hurt that bad, in fact the one he put in my forehead hurt the least, and that was the one I was most worried about.

   Finally after my appointment I had the first meeting of the Dragon Boat Club! (super excited!) We're not going to be doing any paddle practices until at least Februrary, but it was good to meet some of the people interested in it and start working out together. We ran outside for around 20 minutes, and then did some working out in the gym. Wow have I gotten out of shape! This is definitely going to be a good experience to get back in shape, and I'm really excited about getting out there, especially in the summer when the races come.

Automatic Perceptions, and Mindfulness

   We had our second psychology practical today. It was pouring rain and Dr. Creech was running late, so one of the more experiences TAs started the class with a little bit of meditation, and then went over the lecture portion which related to automatic perceptions, especially with respect to transference and counter-transference in the doctor-patient relationship. Transference refers to when someone (e.g. the patient) puts an unconscious redirection of feelings onto someone else (e.g. the doctor) based on their feelings about someone else. For example, if a patient is mad at a co-worker and the doctor looks like their co-worker, they may act mad towards the doctor even though they aren't actually mad at the doctor. Counter-transference refers to the opposite, specifically when a doctor is emotionally entangled with a patient based on predispositions. For example, a doctor may show protective feelings over a female patient, and then realize through discussion that it was actually because the patient reminded them of their little sister.

   Transference and counter-transference are automatic processes that cannot always be controlled, but the important things as a clinician is to be aware of them when they happen. If you are not aware that they are happening, then that is where the negative effects really come into play. So once again the topic of mindfulness came into discussion during our small group talk today, and I really liked a new point that Dr. Ragbir brought up. There seems to this distinct connotation of the word meditation in which you imagine a person sitting in a quiet room with their eyes closed, maybe with the lights off, just breathing, maybe even doing some sort of humming or chanting.

                                                 Pretty classic looking meditaton here right?

    Now of course there is nothing wrong with that picture of meditation. In fact it is a very healthy way to relax and bring oneself into their mind and awareness, and to pull away from the stresses of their life. However, this does not have to be the only way to be mindful and meditate. Dr. Ragbir talked about a Buddhist monk named Thich Nhat Hanh, one who has been compared to the Dalai Lamai. He explained that when asked about what he does to be mindful, Thich said that he is always mindful. He is always aware of himself in all ways, because you really don't need to get into that quintessential meditation practice in order to be mindful. All it takes is practice and most importantly, removing any judgement upon yourself in the journey to mindfulness. Again there is this belief that to be mindful, you need to have completely unwavering thoughts, focused just here on the present moment (I should know, that's why I thought I've been meditating wrong all along). But in reality, it is not the way that you meditate that makes you mindful, it is just the awareness of what you do. Whether your mind is focused solely on the tides of the ocean, or if your thoughts drift to your schoolwork, and then traffic, and then what you want to do next weekend, they can all be true mindfulness, IF you are aware of what it is that is going on. Practice awareness, remove the judgement, and just do it for yourself and you will see the benefits that mindfulness brings.

     On another quick note I just wanted to mention that I did end up going all out for the Halloween costume yesterday, wearing the thing 2 costume (wish I'd thought to bring thing 1 and share it with a friend; oh well, maybe next time). It was pretty fun though laughing with others about being really silly (not to mention Dr. Terzic said to me, "Noah, I thought you were a serious student" --> I think he was kidding, after all it's okay to let loose sometimes). Not to mention Bonus! I came in third place and won a Starbucks gift card! Can't wait to top it next year.

There's me on the right, my friend Alex as batman on the left, and someone I don't know in a really sick scarecrow costume in the middle.

                                               

Cool Marine Video, and HEROs Class 2

    Today in homeopathy, one of the remedies we learned about was sepia officinalis (sep), aka cuttlefish ink. I won't go on about the details of this remedy, but Dr. Byden-Tailor showed us a really cool video of a cuttlefish before we started learning about the remedy, I really recommend watching it here just for the wow factor (I know its over 4 minutes, watch if you're interested, but if you're time is limited the first 20 seconds are all you need for the really cool part).

   I also had my second HEROs class today, which was the second part of Starting Smart/Leadership. Today was once again a little bit scary and overwhelming, but at the same time made me feel good about my choice to take this course early. My future in the business world is a bit of a scary thought, but it is an important reality and I know that if I procrastinate and wait too long, I'm only going to deny my own success, and with that, deny my ability to help people improve their health.

   So the focus of this class was really on where you can go as an ND. It seems that employment is not a big area for NDs --> it's possible to work for a supplement company, to teach or work for a government agency or other NPO (non-profit organization), but these opportunities are limited. There are also some residencies available, but these are limited, and also not long term. So the main opportunities really involve working for yourself. But, there are some possibilities that don't have to be you opening an office for yourself. We talked about partnerships, sole proprietorship, being an associate, and the management model (or zero partnership entity). What I learned is that partnerships are definitely a bad thing unless it is with a significant other (they seem nice, "us against the world," but once the talk becomes about money, there are problems, especially if one of the partners has a divorce with their spouse), and that sole proprietorship is the way to go if you have the resources to do it successfully (with the ultimate goal of hiring associates and building a successful "Clinic," rather than "Practice").

    However, if resources are tough then being an associate or the management model can be an effective way to start. We talked a lot about the details of contracts and the economics of things, and it's sad to hear that the situation around contracts within the naturopathic professional community is very bad. It really is just that a lot of naturopathic doctors do not know enough about business, and so a lot of bad contracts are written that lead to poor, win-lose situations. My hope is that with the knowledge from this course and Andre's help (fortunately with taking HEROs, my first contract review from him in the future is free), I can avoid these situations and get myself into a win-win situation first thing.

    That's all for now, off to bed and then tomorrow is Halloween (well October 30, but we have common time so there will be some fun events). I'm going for the costume contest as a pretty silly costume, but it should be fun!

This isn't me, but it is the costume I plan on wearing tomorrow. Go big or go home!

First Health Psych Practical!

    Today we had our first of 6 practical sessions in Health Psychology. This is pretty exciting because up until now, the majority of what we've been doing has been theory through lectures, with the exception of anatomy labs (for now just looking at bones --> real ones not models, but still not that crazy yet), and physiology labs (though hematology didn't include much work, and our spirometry lab was also mostly answering questions, not much practical application yet). So I'm pretty excited to actually start doing some practical work.

    The class started with a "short" lecture about naturopathic intake interviews from Dr. Creech (1 hour, but that's short compared to the normal 3 hour one). We then split into a bunch of groups and went off to different rooms (my group unfortunately had to stay in Classroom 4, especially bad because it was really cold today), each group getting assigned a TA who is an ND. My TA for the class is Dr. Rajesh Ragbir. He's a pretty interesting guy, considering that he was some sort of mechnical engineer before he changed his career path to become an ND (he used to fix and automate A/C and heat systems).

    The class was relatively easy-going for today. We just got into a circle and all introduced ourselves, talked about what our experience in health psychology was and what we were hoping to get out of the class. Then we talked about some different strategies when speaking with patients, the one that really stood out to me is from the acronym OARSS.

O - Open-ended questions. Dr. Ragbir really emhpasized that we should ask questions with a genuine type of curiosity. Even if you know the answer to something, you should still ask as if you don't know, because this way you get the most information from a patient that can be helpful to the case. For example, if a patient comes in and tells you that their family doctor recently diagnosed them with type II diabetes, obviously a naturopathic doctor knows what this means. But by asking a question like, "what does that mean to you?" you are able to learn how much the patient knows about the disease and how it will affect them, and even draw out other information about emotional and spiritual effects. Open-ended questions are very powerful, and definitely have a very important place in the naturopathic interview.

A - Affirmations. It is important to affirm what the patient says because it provides them with an understanding that you as the doctor trust and believe in them. This helps to build rapport and more importantly, strengthen the relationship between doctor and patient that can lead to successful treatment.

R - Reflections. It is also important to provide the patient with reflective statements on what they have told you, because it is an effective way of communicating empathetically, and this obviously has a lot of merit in practice.

S - Summarize. This is a very key step to interviewing, because it shows the patient that you were listening and helps them to feel "heard." This is a very important aspect of the naturopathic interview, because many patients come in feeling that they haven't been fully heard, and by summarizing you can validate their feelings. In addition, this step allows you to confirm if you understand what the patient has told you, allows them to correct any mistakes in the information you have taken down, and finally, it may draw out more information that they didn't think about at the time.

S - Silence. This last S is actually an addition (the real acronym for motivational interviewing is OARS), but Dr. Ragbir liked to add this one because silence is also a key aspect. Many interviewers can get worried and uncomfortable about silence, but it actually has a lot of power if used effectively, and can strengthen the doctor-patient relationship. "Silence is golden," can really be true in this situation, as effective use can provide a lot of benefits during the interview.

That's it for today, looking forward to the next practical where we'll focus on automatic reactions (which I bet I have some serious trouble with, body language!), and hopefully get into even more role playing and examples.

HEROs 1st class

    Today I had my first HEROs class. HEROs stands for Helping Everyone Realize Opportunity. It is a course run by business coach Andy Belanger, and is also known as the Health of Business Business of Health course in the United States http://www.hbbhealth.net/. At some of the naturopathic colleges in the US it is a mandatory course, while here at CCNM it is an extra course. Well I am glad I took it, and will go over a little bit of what we do each day. The course involves 4 modules, the first 3 taking place on Monday or Tuesday nights (I'm going to Tuesdays since I have Physiology Monday nights), and then the last one on a weekend in the winter. The modules include Starting Smart/Leadership, Operations, Marketing, and Administration/Accounting.

   Andy has been teaching business to health professionals and working with naturopathic doctors specifically for 26 years now, and it seems like he has a very strong understanding of the field and of what it takes to be a successful naturopathic doctor --> on the entrepreneurship side. I say this because the majority of people who go to school to become NDs will likely have the skills and ability to be very successful and strong doctors, but the problem is that you also need to be an entrepreneur. It would be amazing if we could help people be healthy and that would be that, but the reality is that we need to be successful business people in order to that. If we are struggling financially to live keep our offices running, or even to survive in your personal life (pay your mortgage, buy groceries), then we wouldn't really be able to help a lot of patients. Also, marketing is such a key aspect of naturopathic medicine because so many people still don't know about it or understand the benefits they can get from it, so we can't really help people until they know we exist.

   So the first class today was on Starting Smart and Leadership. Andy provided a bit of an overview of the course, and talked to us a lot about what you need to do to hit the ground running. We talked about goal planning, business plans, how to properly "position" yourself in the market (how to determine where to set up an office and what kinds of things you should do to ensure that you have the correct services to provide for that area), and talked a lot about what successful and unsuccessful people have done. So I'm very excited to move through this course and work hard to learn from it, and use the lessons in my planning for the future so that I can be successful and help lots of people in the future. I'll continue to comment on the next sessions in the future (with the next one being next Tuesday).

Medical Equipment!

   So after our final biochem midterm yesterday (woo finally done!), our Clinic rep Alex had an awesome medical equipment demo for us at his apartment. He's been doing a really great job of setting everything up for us and trying to get us the best equipment and best deals --> I'm very impressed and glad I voted for him. So Ken from Steven's Medical Group (a great company, my Garan said he actually used to deal with them for medical equipment for his office) brought in all the Heine equipment including sphygmomanometers (blood pressure gauges and cuffs), diagnostic sets (eye and ear scopes), and stethoscope. He also brought in Littman stethoscopes and Welch Allyn sphygmomanometers, though he actually had to do it in a separate room (another rep he works with was there who exclusively shows Heine equipment, so he had to do that because of conflict of interest or something).

   I tried out everything, it was pretty cool checking out the eye and ear scopes and actually seeing everything. I was also really happy with the Littman stethoscopes --> I've tried a stethoscope before in my physiology class at Laurier, but the quality was really poor and I could barely hear anything, so it was good that the one I'm going to buy had great sound quality.

   So in the end I ended up buying the Heine diagnostic set and sphygmomanometer, the Littman Cardiology 3M stethoscope (great sound quality, bell and diaphragm for high and low frequency sounds as well as easier to use for pediatric patients), and all the extra stuff we need (reflex hammer, tuning fork, eye chart, pen light and thermometer). We only need the sphyg and stethoscope for this year, but I got a great deal buying everything at once. The original deal was if you got a Heine sphyg and diagnostic set, you'd get a free stethoscope --> I really didn't like their stethoscope and couldn't hear much, so Ken was really nice and gave me a $147 credit rather than getting the stethoscope, so it was definitely worth it in the end (though everything together cost me over $1300! Hopefully I'll use it for the rest of my life though, so then I guess it's worth getting the best stuff).

   I'm pretty excited to have my own professional equipment (which I'm sure I'll bother my family and friends with a lot when I want to practice using them). When I get them in a couple of weeks I'll definitely post some pictures of them, but for now here's a picture of the stethoscope I got:

Here's the funniest one you can get --> pink tubing with a rainbow chestpiece! I obviously didn't get this one because it may make patients find me, just a wee bit unprofessional (I think this is more for pediatric doctors). Pretty funny though!

Midterms

    Finally finished midterms yesterday. 5 midterms in a week was pretty intense, especially because my brother came in from North Carolina for Thanksgiving and that really cut into weekend study time. Oh and not to mention that three of my exams were basically in another language (Botanical Medicine, Homeopathic Medicine and Asian Medicine). Overall they went pretty well though, and it was nice finally getting to relax last night after studying every day for the past 15 days! I'll do a quick recap of what the exams were like.

Tuesday morning --> Anatomy
Dr. Terzic wrote a pretty fair exam. It was 85 multiple choice questions, 3 questions were matching but the rest were just straight up. Overall it wasn't so bad, I just had a little trouble remembering exact locations of some ligaments and muscles. The practice midterm questions someone put up on facebook were really helpful.

Wednesday --> Botanical Medicine
This was a pretty hard exam. All multiple choice (I think 50 questions). Quite a few questions about specific actions or names of phytochemicals. I think knowing the specific classes well would definitely help with this, also knowing some specifics from the safety stuff (especially about how to affect specific parts of liver detox, not just phase I or II) would've been good.

Homeopathic Medicine
This was a pretty tough exam with 50 multiple choice questions, just because knowing the remedy pictures was so hard for me. The stuff not related to remedies, like philosophy and terminology was actually not bad, I knew most of it pretty well. So just knowing the remedies better would be good; there was lots of questions about specific cases and what remedy should be used. The really tough questions asked "what would be the best question to ask to determine the correct remedy?" To help with this, it would be great to determine key difference between remedies.

Thursday --> Asian Medicine
Having past midterms was really helpful for this exam, but also it just wasn't so bad overall, with 60 multiple choice questions. Asian medicine seems daunting at first, but the more you study the more everything makes sense. There was a lot of questions just giving you symptoms and asking what pathogen is involved and stuff like that. There was also 3 full case studies, but then he gives specific symptoms from the list and asks questions about them, so you don't really need to read the case studies. As long as you know elements, pathogens, patterns and vital substances well, there really isn't any tricks in this exam.

Friday --> Biochem
This exam wasn't too bad because I've taken biochem already in undergrad, but also because it really followed our assignment closely. If you did well on the assignment, or made an effort to ensure you understood the stuff from it well, then it should be okay. The only real curveball of a question was about epimers and anomers --> kind of random stuff from our first lecture, but aside from that just following the assignments and past midterms on google drive was really helpful. The whole exam was short answer which was a bit of a change, but it really wasn't so bad since going over all the material and assignments made it pretty easy to talk about. And fortunately you can write point form so you don't have to kill your hands.

So that's it for the first set of midterms, 5 wasn't so bad, though 8 during finals will be interesting!

Where do we go from here? Part 1

   Even though I'm busy studying for midterms (they are creeping up!), I still decided to go to the NMSA seminar tonight. Where do we go from here? is a 3 part seminar series they are holding to help students get a grip of the future and be aware. I think it's a great idea --> it's easy to get caught up with school and studying and all that, but in the end, we're here to become doctors and go treat people. So it's definitely great to hear about experiences of people who are actually doing it.

   The first part of the series was Interns, and that was tonight. We were in classroom 5 (though I went to classroom 4 at first and was worried no one was there, I guess because 99% of first year is in that room I just assumed!), and there was a fair amount of people, though it seemed like most of them were in third year. They also had pizza which was pretty good, though a lot of people showed up so I only got one piece.

   Anyway to the point! So basically there was a panel of about 10 fourth year interns that talked about their experiences in the clinic and answered lots of questions. There was pretty good representation of fourth years, with interns from all four of the specialty shifts and several of the satellite clinics. They also talked about externships, though none of them had done one at the time, and may not be doing that anyway.

   So I'll talk more about some of these in the future, but here are all the current shifts available for CCNM interns:

Regular Shifts:

Monday 2:45pm-7pm
Tuesday-Friday 8:45am-7pm
Saturday 8:45am-3pm
Sunday closed

Interns work during these shifts with all kinds of patients. They have about an hour of "preview" at the beginning (meet with supervisor and all co-interns on the shifts --> go over some of their current cases and what they plan to do, make sure it is okay with the supervisor; get all paperwork and everything in order), see patients for 4 hours (I think a max of 4 patients at RSNC, satellite clinics and externships can see more depending on the situation), and then "review" (go over what they did do in their big groups, maybe learn about specific topics from their supervisor like HIV, vitamin D, anything relevant).

Specialty shifts: These are limited so only people who really want them do it. They also limit you from doing the one month externship

Sports Medicine --> focus on athletes, lots of nutrition and musculoskeletal stuff (this is where I actually see my intern since I always get hurt!)

Pediatrics --> working with kids anywhere from a day old to 18 years old (the parents actually stay in the room for most of the visits, but you are treating the kid --> great for preventive health care!)

Fibromyalgia/Chronic Fatigue Syndrome --> really great shift helping people that in many times, conventional medicine and mental health professionals give up on and tell them it's all in their head, when really it is quite physical and we can do a lot to help them

Adjunctive Cancer Care --> very intense shift, great learning opportunity, and get to help with IV therapy (supporting patients, we can't learn parenteral therapy until we are licensed I think)

Satellite clinics: (all of these are free for patients, and generally a very different income bracket so treatment can be a little different; dispensories are available but based on donation so a lot of it is acupuncture, physical medicine and counselling)

Parkdale Community Health Center (Queen and Dufferin)

Sherbourne Health Center (Toronto) --> a lot of work with patients who have HIV

Anishwabe Health Toronto --> a lot of helping patients who are Aboriginal

Queen West Community Health Center (Toronto)

Brampton Civic Hospital --> really cool integrative learning clinic --> the first and only naturopathic clinic within a hospital (but there will be more soon I'm sure!)

LAMP Community Health Clinic (Etobicoke)

Externships:

So you can do an externship for one semester that is 1 day per week --> this may be with an ND who is from your hometown or out of the city or something, but this is during regular shifts as well

You can also do a one month externship in August, November or Februrary --> some people take this opportunity to go to their hometown in Canada (we can't currently go to the US for insurance reasons)

Thats all for now, time to make lunch for tomorrow and then off to bed before another day of midterm studying (woo...)

Front desk at RSNC. I like how the walls are a brighter colour, compared to some medical clinics that can be a little too white (the bright colour keeps your mood up!)

Midterm Studying

   So it's Monday night, 8 days before my first midterm and I'm sitting at home studying for the last few hours, after already studying for a few hours Saturday and Sunday. 10 days before a midterm? That's something I would never have done in undergrad. Maybe for a final, but definitely not a midterm. Why the change? Maybe because I have 5 midterms in 4 days, 3 of which are practically in another language! It's definitely going to be an interesting ride next week, but I'm working hard now and have a pretty good study schedule to get myself as prepared as I can (again something I would never have done in undergrad, but with the way things are it seems like a good idea, and I hope it goes well).

   One thing I wanted to mention today though was just how great my class is. Everyone is very supportive and wants to help each other succeed, and it really feels great to be part of this community. We have a gmail account which we share and on the google drive, everyone posts lots of stuff to share and help each other out. We also have access to the 2nd, 3rd and 4th years accounts, and there is plenty of useful information, study notes, and even practice exams that really help with studying. All of the information is really great to have, not to mention that my classmates are so diligent at posting on the facebook group if they've added or found anything new and useful for everyone else to download.

   So it's definitely going to be a tough first midterm break, but at least I've got the support and help of a lot of great people to get through it. On that note, I hope anyone else studying for exams out there is doing okay with it. And tip of the day (since I feel like I should probably post something useful for the readers out there): make sure you take some time for yourself. No one can effectively study if they just go straight for hours on end; you won't retain all of it and you won't feel so good either. Take frequent study breaks to get up and walk around, get a snack, and even set goals for yourself and your studying. When you achieve them, reward yourself with a TV show or hanging out with friends. It makes studying much more bearable, and makes it a lot easier to get back to it when you're done.

     It's hard and there's a lot to know, but a good plan helps make this a lot more manageable

Early Practice Management Tips

     We had our last Clinic lecture this morning, my SOAP charting assignment has been handed in, and now all I need to do is go to my clinic shift on November 23 (really excited about it, sad it's not for so long), and write the reflection for that. What I want to talk about today though was the presentation we had before our lecture started. We were lucky enough to have Jonathan Wilde come in and talk to our class for a little while before we started looking at case analysis. Jonathan is the teacher for Practice Management in third and fourth year, but it was nice that he came in to have a short talk with us today.

    I really liked listening to Jonathan because he went over some key points that I think are really important. First and most important is the importance of business in naturopathic medicine. Of course the vast majority of naturopathic students (including myself) got into this field because we want to help people to live better lives; if we wanted to make lots of money, we would've gotten into some sort of business. But it is important to remember that we are still part of a business. Business includes things like marketing, and they are so vital to naturopathic practice. Of course we want to help people, but if you don't have any patients, then you can't really help anyone.

    So hopefully the practice management courses in third and fourth year will be helpful, and I've also signed up for the business club and will look into other avenues for some extra business education to help in the future (great that I've got some accountants and lawyers in the family), but here are some of the great tips that Jonathan gave us that we can start right now:

1.  Get a website so you can start getting your name out --> hopefully by working on this blog I've started that a bit

2. Preceptoring --> I think a lot of people see this as something you need to check off your list, just get as many hours as you can as quickly as you can, and likely with few practitioners so you can just get a lot of hours done faster. Jonathan's presentation really reinforced a key aspect of preceptoring --> working at the front with the receptionist and asking lots of questions about the business. It is obviously important to watch different practitioners with patients and learn from their interactions, but the business side is a key aspect which should not be overlooked. Preceptoring under many practitioners, asking lots of questions, reflecting on the experiences and learning what works well and what does not are key activities that can help naturopathic students prepare for their futures in business.

3. The obvious one --> getting out there. Everywhere you go, when you meet new people or when you're talking with friends and family, it is important to be proud of what you do and are going to do, and to educate people. Developing a strong elevator speech about naturopathic medicine helps to provide people with the information they need to determine if they want to know more, and to know that you are a reliable source for information about this wonderful field.

Mindfulness

    Health psychology was a really great class today, talking a lot about empathy and how to effectively communicate with patients, and people in general to ensure that they feel heard and that what they say matters. Before the full lecture though, we talked again about mindfulness and being in the present moment. To solidify this talk, Dr. Creech took us through a guided meditation in class, and then gave us a break to go outside and enjoy the sun. The whole experience has given me more understanding of how important mindfulness really is. We spend so much of our day thinking about the past and the future (even as I write this I'm worrying about work I have to do later tonight), and yet the present has so much importance. Past and future are important, but it is really the present where we actually exist. A smart guy once said, "life moves pretty fast; if you don't stop to look around once in a while, you might miss something."

   Through our discussions about mindfulness, I've also come to realize how important it is when it comes to speaking with patients, and also with our friends and families, really anyone we speak to. Think about the last time you spoke with someone, anyone. Were you completely in the present moment while you listened to them, or did your mind drift off at times onto things what happened that morning or what you need to do later that day or even right after you finish talking? It can be very difficult to stay present because our minds have so much information, how could they not wander? However, exercises like meditation and practicing mindfulness have the ability to get you focused on what is happening right now, and with practice comes to ability to remain present when you need to. This is something I plan to work on myself as I go through the program at CCNM, because my hope is that when I am in the room with patients in the future, I can forget about everything else in my life at the time, be mindful and present, and provide the patient with what they need. Hopefully this will also transfer to my social life as well, because though patients are obviously important, the important people in my life deserve the same attention as well.

    For those of you who would like to work on their own mindfulness, I suggest trying a short guided meditation such as this one. It is important with meditation to be in a quiet room where you can be comfortable, get in a comfortable position and close your eyes. Focus on breathing in through your nose and out through the nose because this engages the parasympathetic nervous system which will help you remain relaxed. Just focus on breathing in slowly, taking a pause, and then breathing out slowly, and repeat. As you focus on your breath and the sensations of your body, past and future dissipate from your mind, and the practice of mindfulness really begins. It is difficult and takes a lot of practice (I'm nowhere near where I'd like to be yet), but the benefits are well worth it.

(if animals really are like this, it must be nice to be so present with little worries)

Carotenoid "Glow"

             Monday’s botanical medicine lecture was pretty interesting. We just continued looking at different types of phytochemicals, but we also got to smell and taste a lot of essential oils. Some of them have very intense smells! One of the phytochemical categories we looked at today was tetraterpenes, also known as carotenoids (such as beta-carotene and lycopene). This brought up an interesting discussion about something known as the carotenoid glow. In addition to many of the health benefits that carotenoids provide (e.g. some carotenoids are “provitamin” A), they are also pigment molecules that can have an effect on the colour of your skin. The yellowish colour of your skin is influenced by melanin (which changes in response to the sun) and carotenoids. In a recent study in Evolution and Human Behaviour, researchers found that people found skin that was yellowish due to carotenoids looked healthier and more attractive than skin that was yellowish due to melanin. This is great news because it means you can eat healthy to get all the health benefits of carotenoids, and also have better looking skin without needing to do lots of unhealthy tanning. So get out of the sun so much and make sure you eat lots of vegetables, your body will thank you, and your skin will look great!

(the face in the middle shows the woman’s natural colour, the face on the left shows the effect of sun tanning, and the face on the right shows the effect of eating more carotenoids over two months. What do you think looks better?)

Clubs Week

        This week was clubs week which is overall a pretty exciting time. I’m used to Laurier where there is one day devoted to clubs for first years during orientation week, and then occasionally they set up in the concourse. For this week, the front lobby was set up with a bunch of tables, and over the week tons of sign-up pages were set out for a bunch of different clubs. I was really impressed with the number of clubs there are (over 20) considering that the school population is so small (can’t be more than 500-600 students), compared to Laurier which maybe has 50 clubs, but over 14000 students! I signed up for almost all of the clubs since I decided it would be better to get all the emails and decide what to go to when I get them. One of them I’m pretty excited for is the Dragon Boat club (CCNM Nightshade!). I think we’ll just start with working out for this semester, but in early winter we get to actually go in a dragon boat and race, so that’s going to be pretty exciting. There’s also lots of cool clubs to learn about different topics with free lectures and seminars, like the business club, pediatrics club and geriatrics club. 

                           (a real dragon boat in action, it looks like a lot of fun!)

Graffiti Pub

         It’s the end of week 2, and the NSA just ran a really great event called Graffiti Pub. This is another event that’s supposed to help first years bond, and also helps the first years meet some of the upper year students. We were all given a white t-shirt that had our class logo and said “Class of 2017,” and the graffiti was to use permanent markers and write messages on everyone’s shirts. The party started in school which was lots of fun, and then we moved together as a huge group taking the subway to get to Yonge and Eglinton. There we got to a bar and met up with the NSA, and eventually some upper year students we got to meet. We had a good time with some food and beer, and messing around writing messages on everyone’s shirts with markers. There were lots of funny messages, I got to know a lot more names, and had a really good time with everyone. It was definitely more of a first year event, but I did get to meet a bunch of upper years too, and even got to see Vanessa (my Unity Summit team leader) again. All in all, it was a good night to relax after the first full week of school.

(group picture in our shirts at school before heading to the bar; mine wasn't cut yet so it's kind of boring here)

First Full Week

     It’s been a whole, full week now and I have to say, I’m pretty exhausted. This is definitely a lot more school than undergrad was, especially last year since I had so little class (jeez I had Monday and Friday off second semester last year, and now I have 11 courses!). Anyway here is a list of the new classes I had this week

Monday

Botanical medicine: Dr. Gowan teaches this course, and he comes from a background in toxicology so he has a very interesting take on everything. He’s explained that this course is like learning a new language, so it’s definitely going to be hard. But I’m pretty excited because it seems like a pretty cool topic; we’ll be learning the basics of botanical medicines which include things like teas, tinctures and essential oils. I also hope to be able to spend some time in the Paracelcus Herbal Garden and actually be able to identify some plants in the future.

Clinical physiology: Dr. Gratton teaches this one, and it looks like my background with physiology and having taken physiology in my last semester at Laurier will definitely be helpful. I like how the concepts are very clinically focused, and we’re going to do practicals where we get to apply what we learn in the lectures directly; it’s especially great that practicals are during lecture time, so this means there will be less lecture material overall. I’m especially excited for vitals when we get to learn to take blood pressure using a sphygmomanometer and listen to heart sounds with a stethoscope (and buy my very own medical equipment!).

Thursday

Health psychology: This is going to be a really interesting course, one I’m very excited for. I think one of the things that worries me the most about being a future ND (aside from the business stuff) is patient rapport and being able to deal with all the mental-emotional stuff. Dr. Creech has a really good background in psychology and it looks like we’re going to get a really good foundation here, especially with a lot of practicals to actually put the theory in action.

Asian medicine: So we do have Dr. Montgomery (my intern Shahin said he’s really good), but this course is still kind of scary. Again we’re told that this course is going to be like learning a new language. It’s definitely going to be interesting and I can see how this is going to be useful (I mean, TCM has been around for over 5000 years, they must be doing something right), but it’s going to be hard, especially for my scientifically oriented brain. Dr. Montgomery’s two favourite answers I have in my head right now: “it depends,” and “it isn’t always so.” Groan.

Friday

Biochemistry: This is the last new course I have. The course outline is almost the same as CH350 from Laurier, so I think it shouldn’t be too bad. I probably could’ve got out of it, but I think I was a little too worried about having trouble with OSAP after getting out of two courses, so it’s probably better to just take it. Dr. Fraser is a PhD so I don’t know exactly what to expect, but hopefully we’ll look at processes in a way that helps understand some of the treatments I’ll be giving in the future.

So all in all that totals to 10 courses (I was able to get out of research)! Going to be a lot more class than undergrad.

                  (it's only the second week and it feels like there's so much work already!)

Unity Summit

               Unity summit was an amazing time! This was basically like going to camp for 2 days, lots of fun. So we got to school Thursday morning and signed in, and were put into groups, then went on buses with our groups to the YMCA camp in Orillia. On the bus the NSA (Naturopathic Students Association) members tried to keep us awake and get us involved in some bus games, this wasn’t so bad. Once we got there we were immediately put into our groups and told that we had to come up with a skit related to our group modality (my group was manipulation, or Manip! for short). This was a little intimidating in the morning, but we had a few ideas flowing, I’ll get back to that later.

                So after getting set-up in our cabins (kind of dirty, but honestly better than what I thought, I really thought we’d be in tents or something), we met back as a big group and went through the day. There was a good mixture going back and forth between talks from guest speakers and fun events like an amazing race (Manip! won this which was awesome, especially after swimming in freezing cold water at the end and then running across camp with wet shoes!). I especially liked the talk by Bob Bernhardt, it was a lot more inspiring than the original one during orientation (which seemed a little more business, getting out the information he had to). After dinner we had more time to work on our skits, then we did some cool bonding/initation-like stuff outside, and then went inside to do our skits for everyone. My group went first and had a ton of laughs, it was lots of fun to do. Watching everyone else was lots of fun, seeing how creative everyone was. And finally the NSA did a huge skit, pretending to go through all 4 years of school; it was really funny, I was really impressed with what they came up with. After their skit was over, we had a sudden breakout into a dance party which was awesome and lots of fun. The night finished off with a bonfire in the grotto, which was a great time making smores and listen to some talented people play guitar while we sang along and made new friends.

                The next day was also great with more fun activities and speakers. The final activity was another really cool intiation-trust exercise, and by the time we were on the bus going home I really felt part of a new community. Overall unity summit was a really great experience and I highly recommend anyone who goes to CCNM in the future make sure the take part in it. I am definitely considering being a unity summit leader in the future because I know how much fun it was and can be for everyone. It’s was also a really great way to get to know a lot of the people in the program, and I feel a lot less intimidated by the group now.

                                 (aerial shot of the camp, it's a really green and beautiful place)

Second Day

    So today we had a regular full day of classes, nothing special for orientation at all. I guess we have to get started, but at least unity summit is tomorrow which will be relaxing and fun. I still don’t know too many people in the program, I tried to sit beside some new people and talk to them, but it’s still quite intimidating. Oh and I forgot to mention, but it looks like I’m one of maybe 10 or so guys in a program of about 100 people. So ya, intimidating. Anyway here are the new classes for the day.

Principles of Research: This course is taught by Dr. Gratton who will also teach physiology. It looks like a pretty basic research course looking at general types of research and how to do a critical appraisal. I’m looking into getting out of this since I did a thesis last year and think I know research pretty well.

Anatomy: This is the course I’m probably the most scared for since I didn’t do so well in undergrad anatomy, but at least I have the background. Dr. Terzic (pronounced Terzich) teaches this one. He’s an MD from somewhere in Europe, but he’s been teaching here a long time. He seems pretty nice and funny, made a lot of random jokes. Hopefully it won’t be too bad.

Ethics and Jurisprudence: This is the first part to the course, the rest is taught in fourth year, so this just a minor introduction. The class is taught by Professor Pownall, he’s the school lawyer so he obviously knows a lot about this stuff. The content seems a little dry, but it’s definitely important. This course is only once every other week, with the opposite week being dry anatomy labs.

                     (hopefully I can actually label all this by the end of the semester)

First Day at CCNM

Just letting you know, these next few blog entries are going to be retrospective, looking at the first few weeks of school. They were quite busy and so I didn’t really have time to get started on the blog, but once I’ve got these out of the way my plan is to make a post at least every few days just about interesting topics we learn or I learn through my own studying, or student life and other stuff.

So without further adue, the first day of school:

I left home pretty early to make sure I’d get there on time (orientation started at 8:30am...). Unfortunately I had some parking problems at the TTC lot, full! So I drove all the way to Fairview Mall and parked there, and  took the subway back to school, seemed so ridiculous but at the time I didn’t know about any other options, so I felt like I had no choice. I got to school and there was a huge lineup to get our orientation package; I tried to be friendly and talk to people in line, but it was pretty intimidating, such a big crowd of new faces. After getting our packages (including lots of free goodies like omega-3 from Ascenta and protein powder from Orange Naturals), we went into Classroom 4 where I soon learned we’d spend the majority of the year. The morning went with a bunch of talks from upper year students, professors, we had a tour of the school (I talked to a few more people during this time), and then lunch catered by Hearty Catering (organic, gluten free, all that good stuff) in the classroom during another talk. We got to hear from Bob Bernhardt, the president of the school (and an amazing man who has done so much for the school and the profession, I’m sure I’ll touch on him in the future), and also Nick DeGroote, the dean of academics.

After these talks we actually had all 3 of our classes that are normally on Tuesday (on the first day jeez!), but at least they were shortened to 50 minutes rather than the usual hour and 50.

Clinic 1 – This is taught by Dr. Khalili and seems like it will be a useful course. We’re just going to start learning the basics of what working in the clinic is like and the types of procedures that are done (not treatments, but stuff like charting and meetings, how to do patient intakes), and this is going to include a mock patient intake in class, and getting to go shadow one of the supervisors in the clinic later this term.

Naturopathic Philosophy and History – This is a really interesting course taught by Dr. Godfrey. He’s been teaching here for over 20 years and has tons of experience, he’s a pretty interesting guy. The content seems a little over my head to start, getting very spiritual and the words “cosmic consciousness” come up a lot. I guess I’ll do my best to get something out of this class, I mean it’s obviously here for a reason.

Homeopathic Medicine 1 – This course is taught by Dr. Kimberly-Taylor, and is one that I’m coming in the most skeptical about. I did a little bit of reading about homeopathy before school started, and have to say it seems like a really strange concept, and I’ve read a lot of skepticism especially from medical doctors. But I’m going to try to be as open as I can about it, we have 3 parts to homeopathic medicine, one every year. And I know that naturopathic medicine is really good and since homeopathic medicine is a big part of it, I think it’s worth trying to make the best of it. Who knows, maybe I’ll like it.

                After classes ended, I took the advice Dr. Khalili gave us and decided to go to the clinic. I’ve been having a lot of neck pain since the summer (I had 2 massage therapy appointments for it that helped but it’s still there). Lucky for me, Tuesday is the Sports Medicine specialty shift, so my problem is the kind of stuff they’re really looking at. My interns name is Shahin, he’s a fourth year student who has been working in the clinic since the summer so I have some confidence in him. After a bit of an intake with questions about what’s been going on, he started with a cervical manipulation, my first one ever. The popping sound kind of scared the crap out of me, and we actually only went one way. After that he did some acupuncture, also my first time, and used a heating pad. The acupuncture was actually pretty cool, there were a lot of needles in me but I barely felt any of them go in. He also used an electrical stim on some of the needles, and it felt just like a muscle stim that I’ve had in physio in the past. At the end he recommended taking a magnesium supplement (specifically magnesium glycinate) and using some robax heating pads for a little while. I felt pretty good after the treatment, but it’s been a long first day so I’m really tired. Hopefully I’ll feel better soon.

                                                     (The front entrance of CCNM)

Introduction

Hi Everyone! I'm Noah.

I am in my first year of the four year Doctor of Naturopathic Medicine (ND) program at the Canadian College of Naturopathic Medicine (CCNM) in Toronto, Ontario. I have created this blog in order to document my studies at CCNM to introduce people to this field of medicine and give some insight into what it is like being a student at CCNM.

I hope to keep this blog light, fun and readable with interesting stories and useful facts.

You can expect posts about student life, naturopathic medicine and its modalities, CCNM and probably some posts about food as well because I love cooking and baking (when I have time!)