Vaccination and Ontario Public Schools

Back-to-School Tip:

For a variety of reasons, you may have chosen not to have your child vaccinated with one or more vaccines.

If so, please know that a child can NOT legally be refused admission to an Ontario public school on the basis of lack of vaccination. The child's parent or guardian must simply complete the affidavit form available on the Ontario government's web site: http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/GetAttachDocs/014-7470-64E~1/$File/7470-64E.doc

Private schools and daycares, however, may legally refuse to register an unvaccinated child for classes.

Seaworthy Veggies

Getting Our Marine Greens

Those of us living away from the seaside can find many different types of seaweeds available in natural food stores and Asian markets. For their high nutrient value they are relatively lightweight and can be transported and stored in dried form. Great ones to try include arame, spirulina, dulse and wakame. Each seaweed will have its own unique flavor, color, texture, nutrient profile and saltiness. These varied characteristics make sea veggies a fun "food group" to add to soups, stews, rice, legume and vegetable dishes. The sodium in sea vegetables is balanced by a host of other trace minerals, including iron, potassium, magnesium, calcium and selenium, that we require for optimal health. Seaweeds also supply a good proportion of B-vitamins and folic acid, beta-carotene, vitamin A and vitamin K. Sea veggies are made up of about 25% carbohydrate and 25%-50% protein, with a trace amount of fats. Sea algae provide a non-fish source of the essential fatty acid, DHA (docosahexanoic acid).

Wondering how to incorporate sea vegetables into your diet? Here are a few fun ways to get your marine greens:

• Soak dried seaweeds, such as stringy arame, in water for a few minutes until they soften and plump up. Then add to cooked dishes or sweet-vinagery salads.
• Pulverize dried seaweeds in your blender by simply tearing them into smaller chunks and blending (dry) on medium to high setting. About 4-5 sheets of the typical 8"x10"-ish size sold for rolling sushi will fill a spice jar when pulverized into shakeable flakes. Shake these onto foods as a tasty garnish and a salt alternative.
  
• Mix a few teaspoons of dried sea veggies like chlorella or spirulina into your breakfast smoothie or post-workout protein shake. They give a "green" boost and go great with fresh or frozen fruit blends.
• Use sheet seaweeds as wraps for noodles, veggies, rice, beans or meats, and turn dinner leftovers into nifty next-day lunches.
  

For more sea veggie recipe ideas and info, check out my favorite healthy cookbook, "Whole Life Nutrition Cookbook" by Alissa Segersten and Tom Malterre (featured in my Book Club).

Bowel Basics 1.1: Getting Unstuck from Constipation

Constipation isn't fun.

The straining, the cramping, the frustration. For those who experience constipation, defined as the inability to comfortably pass a complete stool at least once daily, the associated feeling of general malaise, i.e. "yucky all over" will be all too familiar, and signifies the buildup of toxins in the body that aren't being eliminated normally through the stools. When the movement of waste products in the intestines slows to a halt, these toxins are then reabsorbed through the intestinal walls back into the bloodstream. That's why we can feel so ill if we get constipated: we are going through re-toxification! Headaches, nausea, irritability and fatigue are all sufferings that can result from even a few days of constipation.

Constipation + Hormonal Imbalance = Worse Hormonal Imbalance

Hormonal conditions in particular are sensitive to constipation, because excess hormones and hormone-like chemicals that our bodies are trying to excrete are readily reabsorbed from the gut into the circulatory system, which allows them to access and re-stimulate hormone receptors on various types of cells.

Constipation and Hemorrhoids

Constipation is a common cause of hemorrhoids because of straining to pass stool. Hemorrhoids are dilated, sore venous blood vessels in the rectum that may protrude outside the body or may rupture and bleed.

Start with Some Basics

To help get your bowels moving regularly again, here are some simple suggestions for daily use:

• Drink 2-3 litres of water daily (sometimes this is all it takes, really!!)
  
• Consume 35-40 g of fibre daily, especially soluble fibre like from apples and oats
• Work your abdominal muscles and get cardiovascular exercise daily
  
• Relax and give yourself a time-out; the digestive system functions in a "rest and digest" state, but shuts down when "fight or flight" dominates.
  
• Avoid foods you may be sensitive to - as a starting point, try replacing cheese and meat with fibre-rich plant protein sources like lentils, beans, nuts and seeds.
• Massage castor bean oil into the abdomen in a counter-clockwise circular direction (up on the right, down on the left) once or twice daily or go to bed with your tummy coated with it.
• Get your daily dose of probiotics through yogurt, fermented foods or a supplement. If you're unsure which one suits you best, ask your ND.
  
• Try a gentle, super-affordable and easy laxative that also provides you with some omega-3 fatty acids and protein: mix 1-2 tbsp. ground raw flax seed in a glass of water; or blend into your breakfast shake or morning cereal, and always drink an extra glass of water or two to allow the gel-like laxative flax fibre to form and do its good work.

When It's Time to Seek Some Help

If you are doing all of the above on a daily basis and are still not having a normal daily bowel movements, then it's a good idea to see a naturopathic doctor or other health care professional to help determine the root cause. We may introduce acupuncture, herbal medicines, homeopathics, specific dietary recommendations and exercises into your individualized program.

Note that cathartic laxatives like senna should only be used on an occasional basis because they irritate the lining of the intestines and can also train the bowels to become dependent on the laxative - which is exactly what people with constipation don't want to happen. Stool softening-suppositories can also be effective, but again, are treating only the symptom rather than clearing away the root cause. Similarly, enemas can be used on occasion to clear out the colon, but are more labor-intensive than you'd like for daily use, and need to be followed up with appropriate probiotics to replenish what they wash out.

Helping patients get on track with healthier digestion is one of my clinical priorities as an ND. Feel free to contact me with any additional questions you may have about how naturopathic medicine can help you develop a healthier digestive system.

Bowel Basics: Introduction to the Importance of Poo

It's a fact: naturopaths talk a LOT about poo. That's because it's important! If you're seeing an ND and have attempted to leave your bowel habits out of the conversation, don't worry, - your good old ND will bring them right in.

• Frequency, urgency?

• Color, consistency, contents?

• Smell, size, shape?

• Float or sink, stick or slide, burn or itch?

You get the picture.

"But why do I have to answer all these questions about my poo?", you ask?

It's because having a clear picture of a person's bowel habits (or lack thereof) gives us really good information about how you are digesting and absorbing nutrients, (i.e. the basis of your health!) what foods you may be intolerant to, how stress may be affecting your digestive system, how your liver, pancreas, gall bladder and nervous system are functioning, what microorganisms may be out of balance, what potentially serious conditions you need to be screened for, and more.

So, we've settled that poo is important. If your stool is routinely something other than a formed, 4-8 inch-long, medium brown, slowly-sinking, minimally stinky, regular (1-3 times daily) occurrence, then see your ND and learn more about how to use your stools as a sign of your health status. IT'S TRUE!

Stay tuned for my next posting: how to get unstuck from constipation.

Prescribing Authority for Naturopathic Doctors

Many Ontarians see their Naturopathic Doctor (ND) as their primary health care provider or "family doctor", as family members of all ages receive effective, safe, natural health care for myriad acute and chronic health concerns from colds and flus to weight management, allergies to arthritis, travel health preparation to pediatric well-child visits. Like medical doctors (family doctors or "GPs"), NDs are trained to function as primary health care providers, utilizing the full range of conventional laboratory diagnostics (e.g. blood work, urinalysis), physical examination, medical interviewing and the latest published research to inform their practice. NDs are also trained to recognize when it is appropriate to refer patients to different types or levels of health care, including medical emergencies.

Prescribing Authority Awarded to Naturopathic Doctors

In November 2009) the Ontario government (all three political parties) gave final approval to Bill 179, including the amendment to the new Naturopathy Act that gives Ontario NDs the right to "prescribe" medicines. More specifically, this legislation secures the controlled act of "prescribing, dispensing, compounding or selling a drug designated in the regulations" for NDs in Ontario. Prescribing authority is slated to come into effect for Naturopathic Doctors in 2012. Why is it so important? For years we have lamented the state of "crisis" that our OHIP-funded health care system is in, and never seems to get out of. Legislators have recognized that Naturopathic Doctors offer tangible solutions to some of the critical issues facing our health care system, by providing cost-effective, low-risk treatment and wellness-promoting education to patients that not only minimizes side effects (a hidden cost of conventional medical care) but also equips patients with the education they need to address the root causes of disease, and prevent and reverse chronic and acute illness. This means that naturopathic health care saves OHIP uncountable dollars both in the short and long term by helping patients get well. Recognizing this fact, the approved amendment to Bill 179 affords NDs the legal ability to work within the full scope of their training, which includes prescribing higher-risk natural substances as well as basic first-line pharmaceutical drugs, where appropriate.

Why is Prescribing Authority for Ontario NDs Important to Patient Care?

Prescribing authority for NDs was recommended by the Health Professions Regulatory Advisory Council (HPRAC) (Critical Links report 2009, click here) in recognition of the need to preserve the scope of practice of NDs to compound, dispense and prescribe medicines that are within their training but to which access is becoming increasingly restricted due to federal regulations including the Food and Drugs Act and Regulations and the Natural Health Products Regulations. HPRAC also recognizes that NDs have the capability to take on a larger role in primary care with access to basic primary care pharmaceuticals.

Prescribing Authority for NDs Means Better Health Care for Ontarians

Important functions protected by the approved legislative amendment include:

• Ensuring accessibility to restricted natural substances when prescribed by a Naturopathic Doctor, e.g. ephedra for asthma, L-carnitine for vascular health, L-tryptophan for sleep, folic acid in doses greater than 1 mg, etc. Currently, most if not all restricted natural substances (especially the herbal/botanical ones) are simply unavailable to the public, as only medical doctors (MDs) would be allowed to "prescribe" them, but they are not typically included in an MD's training.
• Providing prescribing authority for basic primary care pharmaceuticals (e.g. anti-bacterials, anti-fungals) used in common medical practice where necessary. This means, for example, that a patient undergoing naturopathic treatment for a persistent respiratory tract infection who requires the addition of a common antibiotic won't need to be referred to a second clinician (e.g. MD or NP) simply for the prescription (the ND would be able to provide it if needed).
  
• In-office use and administration of emergency or "crash-cart" medicines where indicated (e.g. diphenhydramine, salbutamol, epinephrine, oxygen).
• Clear authority to compound and dispense restricted natural or traditional substances that are or will become restricted via implementation of federal legal provisions including the Natural Health Products Regulations.
  

A Healthier Ontario with Naturopathic Medicine

NDs are primary care providers who can support a turn-around in many of the critical health care issues facing Ontarians and the OHIP system today. An essential part of optimizing the contribution of of NDs to the health of Ontarians is to ensure secure, legislated access to naturopathic medicine according to the full scope of their training. Prescribing authority for NDs means better health care for Ontarians.

For more information and legislative updates concerning the naturopathic profession, please consult the Advocacy section of the Ontario Association of Naturopathic Doctors (OAND) web site (www.oand.org) and my page on Regulation.