Jaclyn Sawyer

 When it comes to accessing health care services, questions come up. Where should I go to get services? Who do I choose for my primary care? What does my insurance cover? Does the doctor’s philosophy of care match my own? It has been described to me as a lonely road to walk when you don’t feel like you have a contact person or venue to have your questions answered. And without an advocate, you feel as though you must go it alone, and learn as you go.

In an ideal world, there would be a patient advocate, or a point person to whom you can address your questions and concerns as you begin the process of accessing health services. You could start there, and enter into your healthcare experience armed with confidence about your insurance coverage or financial responsibilities and also of what to expect of your first visit. The role of a patient advocate is certainly not something that can be expected, so in the absence of such a person, there are many things you can do to be your own advocate.

Do your research. As you are shopping around for a physician or services or a primary care provider or an integrated health care facility, talk to people about their experiences, visit websites, do online research to determine who might be the best fit. There are websites that give reviews of doctors (Angie’s List is one)—but be discerning, remember others’ opinions may be more indicative of their personal circumstances than the quality of the provider.

Know your insurance coverage. Know your benefits before you start the discussion with the health care facility where you would like to seek services. Have a working knowledge of what your insurance plan covers, and then ask questions knowing what you can expect. Make sure what they are telling you matches up with what you know to be true. Cross checking is a far safer route than relying on the health care facility to verify your benefits or expecting that they will only bill for services that are covered.

Fill out your forms. The doctor is only able to obtain a health history as complete as the patient is comfortable sharing. Take the anxiety provoking element out of the health history experience and work on telling your story at home, where you are relaxed and comfortable. Ask for the paperwork in advance so you can do it on your own time. Take time to document the details and bring thorough information into your appointment; don’t try to rely on being able to remember it all sitting in the waiting room! For all those smart phone users out there, there are many great apps that give you a place to document your diet, moods, energy level, and exercise routines—allowing you to keep a good record of information that your physician will likely be interested in—and it will all be available for quick reference right on your phone! If you prefer, paper and pen works well too; the important thing is to keep a record and think of questions that might come up and plan to have the answers ready.

Make a list of questions. Be concise and thoughtful with your questions. It can be overwhelming meeting a new physician and providing a full health history as a new patient with a new doctor—especially if you don’t feel well—and questions can easily be forgotten or overlooked. Have your list ready as a reminder to yourself, and as an efficient way to represent your priorities in the appointment.

You know yourself best. The exciting and conscientious relationship that can be fostered between practitioner and patient begins when you enter into that first appointment well equipped. Be ready and empowered to fully engage in the process of wellness. You are your own best advocate. If you do stumble upon a patient advocate or care coordinator, or patient representative, be sure to share with them what you’ve learned out there, navigating the health care system; it will better inform notions of good patient care. Let’s shape our health care systems together through personal advocacy!

Jaclyn Sawyer is the patient advocate at Sojourns Community Health Clinic. For more information, contact Sojourns at (802)722-4023, 4923 US Route 5, Westminster, VT 05158, www.sojourns.org, find us on facebook, and check out our blog www.reformer802.com/journey2wellness.

By Susanne Booth, ND, PT, Certified Professional Midwife

Many patients come to me with a history of hypothyroidism. This is not a surprise, since the prevalence of hypothyroidism is on the rise. Levothyroxine, one of the drugs used to treat hypothyroidism, is one of the ten most prescribed medications in America. Iodine deficiency is implicated as one of the causes of this recent epidemic.

Remember the blue cylinder of salt with the girl holding an umbrella on it? The signature packaging of the Morton Salt Company is iconic of the era when the US first began selling iodine-enhanced salts on a national scale. Iodine has been added to salt in the US since 1924 after there was a goiter (enlarged thyroid) endemic in the Midwest. Iodine is mostly found near or in salt water and since the Midwest is a long way from the ocean, people were not getting enough iodine.

These days, Americans no longer get sufficient iodine for many reasons. In the case of salt, some may be on a salt restricted diet; others may no longer be buying iodized salt. A lot of Americans eat prepared foods, which certainly contain salt, but because using iodized salt is more costly, the salt in prepared food usually does not have added iodine. Another hidden source of iodine used to come from bread. The commercial baking industry used to use iodine as a dough conditioner, but in the 1980s bakers switched to using bromine. Iodine and bromine are both elements called halogens and compete with each other for absorption and use in the body. Iodine supports thyroid function; bromine does not. Chlorine and fluorine are also halogens; both are common in our environment and an excess of either will affect the thyroid’s ability to effectively use iodine.

Currently, most of us get iodine from commercial dairy products. You may be wondering how iodine, something commonly found in the ocean, is making its way into dairy products. Iodine is known as a great antiseptic and it is common for dairy farmers to use it to wash cow udders before milking. More recently, it has also been added to cow feed.

Knowing that Iodine intake is on the decline, it is important to understand why we need it. In addition to being essential in thyroid gland function (which we need for growth, development and to maintain our metabolism), iodine is also found in large amounts in breast tissue. A deficiency can lead to painful fibrocystic breasts. Iodine is needed for our adrenal glands, which help us handle stress. It is important for good immune function. Iodine is a critical nutrient for brain development in infants. A deficiency of iodine can lead to increased risk of breast, prostate, endometrial and ovarian cancer. Iodine helps to balance the three forms of estrogens in the body, and helps induce production of the safest form, estriol. An imbalance of the estrogens can result in weight gain, mood swings and estrogen related cancers.

If you are thinking of increasing your iodine intake, you should be aware of the different forms. There is iodide (which the thyroid gland utilizes) and iodine (which is found in breast tissue). The science geeks will know that this is just a difference of an electron, but what we need to know is that one form (iodide) is able to combine in salt, and the other isn’t. It is wisest to try to get both kinds in your diet. This is best achieved by getting iodine from a natural source, such as seaweed. The body is able to best convert what is needed from one form to the other when taken in the most natural form. When an excess of the salt form of iodine (iodide) is consumed, it has been shown to contribute to autoimmune thyroid disease and increase the risk of overt hypothyroidism.

Please talk to your health professional before starting any new supplement to make sure it is safe and will not interfere with other medications or supplements. Susanne Booth is a Naturopathic Physician and Physical Therapist at Sojourns Community Health Clinic; (802)722-4023, 4923 US Route 5, Westminster; www.sojourns.org.

By Susanne Booth, ND, PT, CPM

One of the headline pieces on NPR’s ‘Morning Edition’ this week was entitled, “Thriving Gut Bacteria Linked to Good Health”. Researchers say that in addition to aiding digestion, these bacteria might also increase immune and cognitive functions.

One of the reasons I went into Naturopathic medicine was to work with families to help create environments that support strong healthy children. I think that it is best to prevent diseases by starting healthy habits at a young age. There has been an increasing rise, in children, of the incidences of asthma, allergies and food sensitivities. These are preventable problems. The ‘Hygiene Hypothesis’ is a theory as to why there has been an increase in these diseases. This hypothesis is that when children are exposed to both good and bad microorganisms (bacteria, parasites and other infectious agents), the immune system learns from the exposure and gets stronger; and the child is less likely to be susceptible to food sensitivities, asthma and autoimmune diseases. The decreased frequency of these diseases occurring in children of large families where children are exposed to more germs, and the fact that these diseases occur less often in less developed countries, support the hypothesis. Children that grow up on farms have an increased exposure to bacteria and other microbes, and also have a decreased incidence of allergies and asthma.

When we are children, our immune system gets exposed to many organisms. The immune system figures out which organisms are helpful and which are harmful. The wider variety of microbes the immune cells are exposed to, the more mature and stronger they become. Unfortunately, we now live in a germ-phobic world where many soaps and cleaners are made to be anti-microbial. This use of anti-microbial products results in the killing of all organisms, good and benign and bad. With less exposure, the immune system is unable to get practice distinguishing between helpful and harmful bacteria and risks ending up being immature or weakened.

There are many useful bacteria that our bodies need to help digest food and protect our skin. We have 10 trillion supportive bacteria that line our intestines, creating a barrier and preventing harmful bacteria from getting into our bodies. These ‘good’ bacteria, also referred to as ‘gut flora’, help digest our food and make nutrients (like Vitamin K) that we need. We also carry bacteria on our skin, all over our bodies. This ‘skin flora’ helps fight off infectious agents and stimulate our immune systems. We are first exposed to bacteria during birth. As a baby is born, it touches the mother’s skin and experiences her skin flora. Every time the new baby breastfeeds, he or she is exposed to more skin flora, and this helps to start creating the baby’s gut flora. This is how the immune system begins to mature.

It can take up to 2 years for a child’s intestinal tract to fully mature and be colonized with good bacteria. Every time that child takes an antibiotic, the gut flora is damaged and has to begin rebuilding all over again. This is why probiotics can be so important to take after the use of an antibiotic. They increase the speed in which the gut flora is re-colonized.

When the immune system is mature, a person’s body is more likely to be able to distinguish between helpful and harmful bacteria. When the body hasn’t had the exposure and is more immature, there is an increased likelihood that the immune system will start attacking helpful bacteria, food or the body itself. This is how allergies and asthma can get started.

More recently there has been a connection made between increased exposure to helpful bacteria and the prevention of diabetes and other auto-immune diseases and, as NPR reported, the syndromes we associate with aging.

Creating and sustaining healthy families can begin with minimizing or eliminating anti-microbial cleaning agents and hand sanitizers, and re-thinking the need for antibiotics during illnesses. Although there are certainly situations where antibiotics are necessary and important to use to prevent serious illness or disease, they can easily be over-used. Many plants have anti-microbial properties that can be useful in helping fight illnesses while nurturing a healthy immune system.

Susanne Booth is a naturopathic doctor and physical therapist at Sojourns Community Health Clinic. For more information, please contact Sojourns at (802)722-4023, 4923 US Route 5, Westminster, VT 05158, www.sojourns.org, find us on Facebook.

Experience the difference in how you feel with raw, liquid, green nutritious smoothies!

By Brett Avelin LAc

We don’t often think about what type of fuel we put in our cars. The gas we get is already highly processed, refined, and specially formulated for the automobile to perform it’s job—driving. We have a few choices on the octane level, but otherwise it’s pretty simple: insert nozzle, squeeze handle. People who drive cars for a living, such as race car drivers, on the other hand, are very particular about what goes in their tank. They want to run a very specific type of fuel that gives them high performance. If you were to put ordinary gas in a race car, it just wouldn’t cut it.

We are not all race car drivers to be sure, but when it comes to what I put in my tank, yes, I want it not only to taste good, but more importantly I want it to deliver the best performance in the form of energy, mental clarity, bodily function, and lack of pain or inflammation that I can get. Most people focus on the first part ofthat; they want their food to taste good and don’t go much beyond that. Some people try to cut out certain foods and add other healthier foods. This is well and good, but if want real performance from our bodies, meaning the ability to heal, energy to live our lives fully, the ability to think clearly and meet the demands of today’s world, there is a superior form of fuel that only the few take real advantage of—Green Smoothies.

Green Smoothies are a godsend for the modern world. They are fast, easy, fill you up, pack your body with nutrition, and most importantly, make you feel great! Today I spent the first half of the day drinking a couple of green smoothies and felt so light, energetic and focused that when it came time to eat my lunch of tortellini with pesto and cheese, I was quite hesitant because I knew I was not going to get the performance I enjoyed so far. You know the energy to which I refer, happy to be engaged and doing the things that are calling to get done. If you are wondering why you don’t have the energy that you would like, look no further than the kind fuel you are putting in your body. It makes a difference!

How do you make a Green Smoothie? Well, very simply you take some water, some greens (such as romaine lettuce, kale, or parsley), some fruit (such as a banana or blueberries), and some add-in’s (such as protein powder or flax seeds); throw them in a blender, put it on high for a minute or so, pour, and drink! There are many variations and everybody has their favorite way.

Green Smoothies are pretty darn good and they have everything you need. They are fast, easy to clean up after, and they give your body the vitamins and minerals it is craving. You could literally live on these; in fact sometimes I do. A Smoothie can stand alone as a meal or fill in between meals (an excellent idea for those looking to lose weight is to use Green Smoothies for most of the day and eat one sensible meal). At least twice a week I substitute a Green Smoothie for breakfast. That way my body can continue until lunchtime the natural cleansing that it began while sleeping.

Green Smoothies are endlessly flexible. They are made of mostly fruit and veggies, have all the fiber still in them. They will keep in the fridge for several hours or longer because the nutrients oxidize much more slowly than when one juices fruits and vegetables. Juicing fruits and vegetables in a juicer, as opposed to using a blender to make a Smoothie provides more intense nutrition, and is better for someone looking to really detoxify/heal a condition or for people with digestive systems that can’t deal with all the fiber that a smoothie has.

Get Creative! The sky is the limit; the recipe below is just an outline. I am constantly modifying based on what’s fresh or on hand. Change proportions, if you like, to make it thicker or thinner. If you do these with any consistency, you will feel amazing…but be sure to rotate the ingredients, especially the greens, for the maximum nutritional value.

If you are new to drinking smoothies and are looking to use them frequently, looking to live on them for any length of time, for weight loss or to get off medications, please consult your physician before attempting it. You must be supervised and monitored in any drastic lifestyle or dietary change in order to prevent complications.

Here it is. Enjoy!

B’s Mean Green that Keeps You Running Lean

1 banana

2 cups water

1-2 tablespoons chia, hemp or flax seeds

a small handful of blueberries ( or other berry)

2 handfuls of greens (favorites are spinach, romaine lettuce kale, chard, parsley, sprouts)

a splash of almond or soy milk

Optional add-in’s:

1 scoop of whey or rice protein powder

1 tablespoon of Good Fat—avocado, coconut oil, almond butter or peanut butter (The addition of fat changes the taste and consistency of the Smoothie. It is usually not necessary, but adds good calories for skinny guys like me or if you tend to get cold easily.)

1 slice fresh ginger or ¼ tsp cardamom, cinnamon or nutmeg (really good for warming it up!)

a splash of juice—any kind you like—to sweeten it up for newbies and kids

Brett Avelin is a licensed acupuncturist at Sojourns Community Health Clinic. For more information please contact Sojourns Community Health Clinic, at (802) 722-4023, 4923 US Route 5, Westminster, VT, www.sojourns.org, find us on Facebook.

By Alexis Chesney, ND, LicAc

 Lyme disease is a preventable infectious disease transmitted through a tick bite. An organism called Borrelia burgdorferi, a specific type of bacteria called a spirochete, causes Lyme disease. Prepare for a high tick population this spring, as it has been a mild winter. We have not had much of a break; I remember the ticks were still biting in early December.

In 2010, the CDC reported that New Hampshire had the second highest, Vermont had the fifth highest and Massachusetts had the eighth highest, incidence of confirmed cases of Lyme disease in the United States. Contrary to popular belief, fewer than half of patients with Lyme disease recall a tick bite. Fewer than half of patients with Lyme disease recall a “bull’s eye” rash, which may appear three to 30 days after the tick bite.

Prevention is the best medicine. Here are some tips that will help you prevent tick-borne illness:

• Avoid areas that are wooded or bushy with high grass or leaf litter, which are preferable to ticks.
• Be mindful that ticks are active and may bite on warm winter days – a tick becomes active at 28 degrees Fahrenheit.
• Wear long sleeves and pants that are light colored. Tuck pants into socks.
• Conduct a complete body check for ticks when returning indoors.
• Place clothes in the dryer for 15 minutes. Ticks may survive a washing machine, but not the hot dryer.
• Check pets regularly for ticks.
• Create tick repellant with Rose Geranium essential oil. In a spray bottle mix:
  • 1 ounce of Rose Geranium
  • 1 teaspoon of alcohol
  • 8 ounces of water
• Create a tick-free area in your yard:
  • Clear tall grass and leaves.
  • Keep wood in dry areas.
  • Prevent deer from entering yard. Use deer-resistant plants or Dial soap.
• Reduce the risk of infection by removing the tick as soon as possible:
  • Use tweezers to grasp the mouthpart of the tick close to the skin. Tick twisters or a tick key are more efficient than using tweezers.
  • Do not grasp or squeeze the body of the tick, as this may force the organisms carried by the tick into the person.
  • Pull the tick very firmly and straight out.
  • Do not use Vaseline, alcohol or burn the tick.
  • Watch for symptoms: fatigue, headache, chills, fever, muscle/joint pain, swollen lymph nodes, Erythema Migrans (bull’s eye rash) over the next few weeks.

  • Contact your health care provider if you cannot remove the tick.

It is recommended that you make an appointment with a Lyme literate health care provider if you:

• Have been bitten by a tick.

• Find a bull’s eye rash on your body.

• Experience unexplainable intermittent fevers, fatigue, malaise, headache, muscle pain, joint pain, facial paralysis, memory loss.

 The standard treatment in the medical field for acute Lyme disease includes a course of antibiotics. Late stage Lyme disease presents similarly to acute Lyme disease with regards to the flu-like symptoms, joint pain or swelling, muscle pain, numbness or tingling, or facial palsy. At this point, these symptoms come and go in cycles, the joint pain (if present) migrates from place to place, and neurological symptoms may begin. There are various treatment strategies using pharmaceutical and herbal antibiotic therapies, as well as addressing other needs the body has while treating for Lyme disease.

 As a naturopathic physician, I believe it is important to treat the whole person and not just the infection. In order to fight the infectious disease, it is important to consider other factors that are often a part of the picture in order to optimize health:

• Optimizing diet, sleep, stress reduction
• Boosting the immune system and detoxification organs
• Investigating food allergies and hypoglycemia
• Addressing endocrine function (i.e., thyroid gland, adrenal gland)
• Preventing Candida and gastrointestinal upset during antibiotic treatment

Lyme disease is becoming more prevalent in this area. Enjoy the outdoors this season, but remember to conduct a full body check for ticks after you brush your teeth each night – it only takes a minute!

Dr. Alexis Chesney is a Naturopathic Physician and Licensed Acupuncturist at Sojourns Community Health Clinic. For more information please contact Sojourns Community Health Clinic at (802) 722-4023, 4923 US Route 5, Westminster, VT, www.sojourns.org.