I begin every new relationship with my patients by conducting a Comprehensive Health Assessment. This assessment is the foundation that will ultimately drive the patient’s treatment plan. Through conversation and a physical examination, I work directly with my patients to thoroughly comprehend their medical history as well as gain a clear, detailed understanding of their chief concerns. A large portion of this assessment is educational and my ultimate goal is to help my patients feel informed and empowered about the ways that we can improve their health and wellbeing. Patients are welcome, though not obligated, to come in with any recent blood work along with any reports from other practitioners who oversee their health.
What to Expect
The comprehensive health assessment will take roughly one and a half hours to complete. The duration of the intake (or Comprehensive Health Assessment) is relatively long as I take into consideration all of the factors affecting the health of my patients; I look not simply at the patient’s symptoms but also at the elements which exacerbate them.
The intake will begin with a conversation. In my practice, these initial conversations are equally as important as the physical examinations as reflecting upon both internal health factors and external stressors equips me to determine their interconnectedness; ultimately, this is how we will tap into the root of the problem. Patients can expect to discuss their health history, lifestyle, mood and energy levels, and their chief medical concerns in detail. We will thoroughly review their diet, intake of alcohol, caffeine and water, as well as their overall level of fitness. We will also reflect upon the relevant social aspects of the patient’s life (i.e. home life and work life) to document any stresses which might be connected to their health. Along this line, we will further discuss the patient’s family medical history, any genetic predispositions and conduct a thorough review of current medications in order to prevent negative interactions and complete the patient’s profile.
We will then begin the complete physical examination, not unlike one that the patient might receive from their General Practitioner. As we have the luxury time, we will be able to proceed with the physical exam according to the patient’s needs and comfort. Depending on the patient’s concerns, I may do a focused physical examination. Generally, the patient can expect a full system review of their cardiovascular and digestive health. I may monitor, among other things, the patient’s blood pressure, heart rate, respiratory rate, temperature, abdominal function, upper respiratory health, reflexes and gynaecological health (including Pap smears and cultures). Finally, if the patient has no recent blood work from another primary healthcare provider, I may order routine diagnostic lab tests such as a Complete Blood Count, cholesterol, liver function and blood sugar panel.
Upon completion of the Comprehensive Health Assessment, I will be able to effectively develop an appropriate Individualized Treatment Plan for the patient.
Lifestyle Counselling is an integral part of my practice as a Naturopath. In fact, it represents the basis of care that I provide to my patients. While medications, herbs and supplements are extra modalities that help the body to heal, true results are related to changes in diet, stress levels and lifestyle. Following the Comprehensive Health Assessment, we will begin the crucial Lifestyle Counselling that will ultimately help my patients follow their prescriptions, make positive changes and fully implement their Individualized Treatment Plans.
Lifestyle Counselling involves working in close collaboration with my patient to understand which changes can be realistically made and worked into their lives. We will discuss what the patient has done in the past while simultaneously assessing what did and didn’t work. We will consider managing stress, mindfulness, improving sleep, developing a joyful and healthy diet, as well as assessing the frequency and intensity of their exercise regimens. Beyond a regular health assessment, Lifestyle Counselling includes the identification of coping mechanisms and the development of specific strategies that the patient can use to remove the blockages that impede their optimal health.
Through discussion and collaboration, the patient and I will identify which changes need to be made in order to improve their health and wellbeing. Sometimes, we will realize that some of the patient’s needs might be beyond the scope of my practice. In those instances, I am happy to refer where necessary to trusted therapists, life coaches and social workers. While Lifestyle Counselling is always a part of the implementation of the Individualized Treatment Plans, individual sessions can also be booked as required.
Upon completion of the Comprehensive Health Assessment and the development of a clear understanding of my patient’s unique medical needs, I begin to work with them to create their Individualized Treatment Plan (ITP). Critical in this stage of the relationship is our ability to communicate with one another in order to ensure that the ITP we develop can realistically work into their lives. We will work together to set accurate expectations and milestones in order to clearly track any required additions or changes, as well as monitor general progress over time. Rather than completely overhauling the patient’s entire life, I prefer to tweak various standing habits and to build upon other healthy, existing foundations that they’ve already established. In my experience, the ITP will yield greater results when patient preference and feasibility are taken into account alongside their medical history!
I believe that developing a constructive relationship with food is integral to my patients’ health and wellbeing. It has been scientifically proven that specific dietary changes can significantly improve the health of the patient. As such, a thorough monitoring of my patient’s diet and food intake will likely be included in their ITP. Beyond simply tracking calories, we will discuss the importance of the patient’s dietary routine (what they eat and when). If the patient notices discomfort after consuming certain foods (for example: lethargy, bloating or constipation), we might consider an elimination diet or food sensitivity testing to suss out those specific foods that contribute to feeling unwell. Further, I might consider coaching the patient through the incorporation of certain diets (i.e. paleo or eating for energy etc.) into their lives. Where diet is concerned, my ultimate goal is to coach my patients to thoughtfully approach the choices that they make in order to have a positive, healthy and pleasurable relationship with food.
Mindfulness and Stress Management
When the brain senses an incoming threat, it triggers the body to release hormones like cortisol and adrenaline to give it the capacity to react to danger. This response occurs in the sympathetic nervous system and generates what is commonly recognized as the “fight or flight” response. Oddly enough, the body has the same stress response when your work life is overwhelming and when you find yourself running away from a bear.
Further, given the onslaught of stress in modernity, the body is often in such a constant state of tension that the elevated hormone levels fail to neutralize and lead to persistent imbalances. Elevated levels of stress can lead to insomnia, irritability and depression which can then inhibit a patient’s ability to maintain a healthy diet and regular exercise. By incorporating mindfulness techniques and stress management into the ITPs, I help my patients understand the interconnectedness of the body’s various functions and to ensure positive responses to treatment.
Botanical Medicine and Targeted Nutritional Supplementation
There is an overwhelming amount of information circulating the Internet with respect to vitamins and supplements. While their inclusion in a balanced lifestyle is backed by a vast amount of scientific research, medical guidance and supervision are required so that the patient can achieve optimal results. Rather than prescribing a multivitamin or taking a shotgun approach in my patient’s ITP, I will use specifically tailored vitamins and minerals in therapeutic doses to any correct deficiencies and account for genetic variability. In many instances, the use of Botanical Medicine can influence and enhance the body’s physiological processes in a balancing way. Further, the use of Botanicals can even help patients avoid taking antibiotics as their first line of defense.
For example, in conjunction with other treatments, I might consider prescribing Echinacea to stimulate the immune system during flu season, liquorice to nourish the adrenal glands in patients with burnout, vitex to stimulate the progesterone hormone in patients with fertility issues, isolated compounds from garlic as a potent antimicrobial for patients that have SIBO or the use of d-mannose (the active component in cranberries) for patients with chronic urinary tract infections. Eventually, the goal will be to reduce supplementation to the lowest possible levels as health can be maintained with good dietary and lifestyle choices. As with anything incorporated into the ITP, all therapeutically dosed Botanicals prescribed will be verified against the patient’s existing medical regime in order to ensure that there are no contraindications.
My studies as a Naturopath have trained me to consider the human body from a Traditional Chinese Medicine (TCM) point of view; that is, with a holistic understanding of the body’s interrelated functions. Based on the intake done during the patient’s Comprehensive Health Assessment, acupuncture and/or Chinese herbal protocols may be prescribed as a part of the Individualized Treatment Plan; alternatively, acupuncture sessions may be booked as optional or additional treatments for those patients who wish to use it.
What is Acupuncture?
Acupuncture originated as a practice in Ancient China and has been in existence for over 2000 years. It is widely used to stimulate the body’s natural healing mechanisms in order to relieve pain, increase energy, improve immune function and restore its overall balance. Sessions consist of inserting sterile, ultra-thin, stainless steel needles in various points along the body in order to stimulate the specific meridians that activate the nervous, immune and endocrine systems. Different acupuncture points and meridians correspond to different organs and processes in the body. By stimulating them, I can correct for existing problems and enhance the body’s ability to restores itself.
What does it do?
Acupuncture has a wide array of benefits for the mind and body. From a neurophysical point of view, the stimulation of meridians increases blood flow and contributes to healthy nervous system function. Acupuncture further stimulates the muscles which enables them to both fire and relax appropriately. As such, it is an incredibly useful tool for those patients that manage chronic pain stemming from various muscular-skeletal ailments (i.e. previous injuries, osteoarthritis and active or sedentary lifestyles etc.). Further, its use as a local treatment around scarring can help to reduce the affect that this scar has on the fascia. Another component of the practice is the positive contributions it makes to nurturing the parasympathetic nervous system (i.e. the body’s resting, digesting and healing centre). Acupuncture treatments give the body the time and space that it needs during the day and not while sleeping to prioritize health and wellbeing. It is extremely beneficial for any mental health concerns. Finally, we offer acupuncture for those patients undergoing fertility support. Many studies have shown that the adjunctive use of acupuncture in fertility and perinatal care can increase the event of achieving and maintaining a healthy pregnancy.
Specialized Diagnostic Testing provides me with objective data that allows me to guide my patients through their Individualized Treatment Plans in the most effective manner possible. Following the Comprehensive Health Assessment, I might order specific tests for my patient in order to rule out or identify the underlying causes of their symptoms. Specialized Diagnostic Tests are able to track changes over time, are focused on prevention and can identify potential health conditions before they become issues. The tests that I order are generally not incorporated into a general practitioner’s services and are more dynamic than the routine blood tests that the patient might be familiar with. The essential groups that I might test include hormone levels, food reactions and environmental-nutritional toxins and the results provide me with an objective baseline for treatment.
Balanced interactions between hormones are essential to good health and hormone panels provide me with an objective overview of the relevant elevations or deficiencies that contribute to the patient’s symptoms. Hormone imbalances can have a significant impact on a patient’s well-being but with the right information, these imbalances can often be corrected through Targeted Nutritional Supplementation or changes in diet and lifestyle. There are a number of different hormone panels that I can order in order to address mood swings, anxiety, infertility, premenstrual syndrome, depression, fatigue, weight gain, prostate enlargement, memory loss, sagging skin, increased belly fat, vaginal dryness and hot flashes (among others) in the Individualized Treatment Plans.
For patients that present with digestive issues or aggravations correlated to their diet, I will order the relevant tests to assess how their bodies react to specific foods. Food sensitivities and allergies can manifest in eczema, acne, rashes, fatigue, weight gain, joint pain, diarrhoea and vomiting (among others) and can range from mild to severe in intensity. Food reaction tests can provide me with a breakdown of different foods and how the patient’s immune system responds when in contact with them.
In today’s world, our bodies have to process more environmental and nutritional pollutants than at any other point in our evolutionary history. Toxic chemicals and pollutants are found in everything from makeup and toys to water, food and the air. After chronic exposure to key chemicals, accumulation can occur in the body and manifest in the form of headaches, irritation of the nose and eyes, effects on the central nervous system (i.e. impaired movement or thinking) as well as mental health issues. By identifying these key exposures, I can work with the patient to reduce or eliminate them from their day-to-day life in order to alleviate their symptoms.
Bio-Identical Hormone Therapy (BHT) is the topical application of the molecularly-identical levels of oestrogen and progesterone. The topical application of these hormones in physiological doses can be used to address a variety of female health concerns such as patients who fall on the menopause spectrum, patients with PMS and PCOS and those patients who require fertility support.
Checks and Balances
This treatment is highly effective but will never be implemented without a Comprehensive Health Assessment and Standardized Diagnostic Testing to rule out the possibility of contraindications to hormone replacement therapy (i.e. a history of breast cancer) and to monitor the patient’s existing levels of cortisol, progesterone and oestrogen. Should the results of these two assessments indicate imbalances in the patient’s adrenal (i.e. hormone production) and liver (i.e. hormone metabolization) function, I will address the issues with proper treatment prior to beginning BHT. Women presenting with PMS and PCOS symptoms will likely undergo an ultrasound examination. The successful completion of these tests in conjunction with the patients symptoms will form the basis of dosing.
How it works
Bio-Identical Hormone Therapy involves the daily topical application of hormones that can be obtained from a compounding pharmacy with a prescription from myself as a Naturopathic Doctor. The cream is applied in specific formations on the skin and is cycled (i.e. patients will rarely have a consistent dose). The duration, dosage and cycling parameters will be determined by the above-mentioned assessments and patient needs. As a part of the Individualized Treatment Plan, the patient’s hormone status will be checked every few months through objective lab work and the monitoring of subjective symptoms. This frequent monitoring throughout treatment will maintain efficacy, safety and ultimately patient comfort.
Who can use it?
BHT is effective for support in mitigating the symptoms associated with the transition through menopause. Specific dosage can address hot flashes, sleep disturbances and the effects of low oestrogen such as vaginal dryness and decreased libido. Patients with PMS and PCOS can use BHG to address facial acne, anxiety and depression as well as to encourage the regulation of the menstrual cycle. Finally, for women with suboptimal levels of progesterone and a history of early or spontaneous abortion, BHT can be used to regulate hormones and support their fertility.
“The doctor of the future will give no medication, but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease.” Thomas Edison
When it comes to weight management, I support my patients on their journey to optimal health with an emphasis on nutrition. The drive of my work surrounding food is to help my patients understand that good nutrition is not simply related to what they eat, and that the food they eat impacts their health. Culture, ethics, family, community and ingrained habits deeply influence how and what we eat, and I aim to support my patients on their journey to incorporating good nutrition into all aspects of their lives. After all, a thoughtful, balanced diet can reverse many of the symptoms of illness that my patients experience and a positive relationship with food can drastically improve their mental wellbeing.
The Comprehensive Health Assessment (CHA) will help me to identify the patient’s specific dietary needs. Following food sensitivity testing (i.e. celiac panels, candida or SIBO etc.) and an analysis of their various symptoms, I might find it necessary to eliminate certain foods that could be the root cause or source of aggravation for a particular condition. Inflammatory reactions can also be attributed to the way that we eat food. As such, I will help my patients track food hygiene and the specific ways and times that they dine in order to determine whether changes might positively affect their health. For those patients that experience extreme fluctuations in weight or fail to lose weight despite heavy exercise, I will examine the history and progression of their weight loss/gain in order to rule out the presence of any underlying pathological causes (i.e. adrenals, thyroid problems or cancer). Discussion during the CHA will also help me work with my patient to recognize the potential for disordered eating in the form of food avoidances (i.e. eliminating foods for restriction as opposed to ethical preference or physical need) and to help them maintain a complete, balanced diet every day. I want to support my patients by starting from a time in their lives that they felt most comfortable in their bodies. Ultimately, when it comes to successful weight loss, good nutrition represents 80% of the battle and exercise will not yield results without it. Together, we’ll ask: how can we frame this journey in a healthy, positive way?
Following the completion of the CHA, we will use the Individualized Treatment Plan to incorporate the aspects of certain diets that will help the patient given their current health status and lifestyle. Rather than rigidly follow any of a number of fad diets that exist (ex. Candida, Anti-Inflammatory, Paleo, Low Glycemic Index etc.), we’ll pull from here and there to ensure safety and to empower patients to balance mindful eating with the occasional indulgence.
Finally, as always, should patients wish that I collaborate with their other healthcare providers, I have no problem doing so. For those patients whose needs go beyond my scope, I have a diverse network of personal trainers, nutritionists and counsellors that I like to work with.
In my practice, I work closely with families as they move through all stages of childbirth to provide them with safe, helpful and healthy guidance as they grow in number.
Complete support of a healthy pregnancy begins preconception and I am equipped to work with men and women to optimize their health and fertility. Oftentimes, I will guide women in the correct dosage of folic acid, botanics and other nutrients. I can also support men preconception in order to optimize their contribution in the form of libido support, stress monitoring and the development of healthy sperm. During pregnancy and in addition to the care provided by a midwife, general practitioner or obstetrician, I will work with women to mitigate and treat instances of Urinary Tract Infections, varicose veins, nausea, fatigue, mood changes and digestive issues. Pre-birth acupuncture can also be used to ensure that the body’s immune system is robust, thus reducing the necessity of antibiotics. Herbal protocols can be used to strengthen the uterus in preparation for labour and delivery and I am also able to use acupuncture for induction at the end of the pregnancy. Finally, I provide Lifestyle Counselling around what the first few weeks of childcare might look like as well as the natural supports the family can use to transition a baby into the household. Following the birth of the child, I will work with the mother to provide support through nutritional and supplementation in order to mitigate postpartum blues. I will also monitor the mother’s iron levels to optimize health and I will provide support for physical healing post-birth.
Adjunctive Paediatric Care
The core of my adjunctive paediatric practice is aimed at supporting parents in proactively approaching their child’s healthcare to reduce the instances of illness and disease. After birth, I am able to provide the family with care in the form of well-child check-ups, monitoring of the child’s growth and development and vaccination support (N.B. the official stance of the College of Naturopathic Doctors is pro-vaccination). Further, I will provide the family with guidance for next steps including food introduction, teething, and immune support as children enter preschool, as well as diet and lifestyle support as the child grows. Finally, I will address acute issues as they arise including guidance around the management of fevers, diaper rash, ear infections and digestive complaints such as constipation or diarrhoea.