Clinic Notes: Issue 8: The Final One :(

Hi peeps, here we are at Issue number 8 already. At the start, I said I would do this for a few weeks and then see if I like doing it and you like me doing it. Well, I’ve enjoyed myself – far too much, probably! – and some of you have clearly liked it and have subscribed, thank you so much. Sadly, though, it’s taking me away from my clinic and testing work a tad too much and there aren’t enough subscribers coming through for that to be worthwhile.

So, this is the final Clinic Notes – hope you enjoyed my little foray into practitioner support. For those of you who have subscribed, I will send you a separate thank you note with a link to the whole archive and offer you a free ebook/factsheet as recompense. Bless you for following x

Meantime, here’s your final Clinic Notes, enjoy!

INFECTION: MONKEYPOX. The World Health Organisation (WHO) has said the expanding monkeypox outbreak in more than 70 countries is an “extraordinary” situation that now qualifies as a global emergency. The aim is the get countries to take it seriously and develop global solutions. MEDSCAPE. Tim Spector has done a great Monkeypox 101 here too which is useful.

WEIGHT: EXERCISE. Study shows that weight training alongside calorie restriction can aid weight loss so px who can’t do cardio should be encouraged to do resistance/weight training. STUDY

INFECTION: LONG COVID SYMPTOMS. Researchers have identified three categories of distinct symptoms reported by people with persistent health problems after infection:

  • Respiratory symptoms – including cough, shortness of breath and phlegm (5.8%)
  • Mental health and cognitive problems – including anxiety, depression, insomnia and brain fog (14.2%)
  • A broader range of symptoms – including pain, fatigue, and rash (80.0%)

The authors said the symptoms most associated with SARS-CoV-2 infection included some that are already recognised – such as anosmia, shortness of breath, chest pain and fever – but other symptoms identified in the study included a range of other symptoms that have previously not been widely reported, such as hair-loss and sexual dysfunction. MEDSCAPE

BLOOD PRESSURE: CHOCOLATE. I think some choc-loving researchers were desperate to find that having a large bar of high quality chocolate every day would lead to a drop in blood pressure here! MEDSCAPE

ANTI-MICROBIALS. I see Nutri have done a great new infographic on how to choose the best product for killing off various ‘baddies’ including choices for sensitive px and children. NUTRI

TESTING: HAIR. Mineral Check, who I have used for years, have just issued an updated price list so get yours if you’ve not been sent on from Karen. MINERALCHECK

SKIN: PSORIASIS. I see it is Psoriasis Awareness Month. Lifecode have done a post about the genetics involved and here is my own factsheet with some useful resources to gen up on.

CHRONIC ILLNESS: MOULD. Catch up on Lifecode’s Mould Detox webinar, it was fascinating going over two live cases. LIFECODE

CHRONIC ILLNESS: MENTAL HEALTH. A very useful supportive video on how to be ‘happier’ even if you are grappling with a chronic illness. Maybe a good one to share with px who need help to boost their spirits. GUPTA

TESTING: HORMONES. DUTCH have been doing an extremely useful mini-training series of podcasts on Endocrine Essentials if you’ve not seen that. DUTCH

TESTING: DUTCH. DUTCH have added 3 new markers to the OAT section of the test. Love it when they do this, so useful. They’ve added:

Quinolinate is a neurotoxin derived from tryptophan. Quinolinate is a marker for potential neuroinflammation. [That is very useful as I’m always looking for evidence of NI].

Elevated b-hydroxyisovalerate is found as a result of biotin insufficiency. 

Urinary indican is a test that can provide information on bacterial overgrowth in the gut.

For more on these new markers, see here.

PARKINSON’S. Nightmares in older age for no apparent reason could be an early sign of developing Parkinson’s. MEDSCAPE

NEW PRODUCTS: I see Oliver Barnett from the London Clinic of Nutrition has launched a new range of herbal supplements. LCN. So has the former founder of Thorne, with some innovative delivery supplements that look very intriguing. TESSERACT. Always like ones from people who truly know their stuff. Both available from YHB.

Now, as a treat for the last Clinic Notes, I’ve chosen three of my favourite subscriber-only bits to share with you. Going out with a bang! Enjoy, and thanks for coming with me on this trial Clinic Notes journey. Anyone out there want me to write for them/help with practitioner support, just let me know!

GETTING YOUR EMAILS SORTED

The point of CN was to save you time reading the myriad, fascinating emails that come our way as practitioners and give you the quick clinical nugget. If I’m no longer doing that for you, you’ll need a way to keep control of your inbox, so here’s my tip:

I don’t know about you but I must get at least 50-60 emails a day, often more. When you get so many, it’s imperative that you find a way of dealing with them efficiently. You may have your favourite strategies, but just in case, here’s mine.

I have a Gmail account with several email addresses. So, most business and clinic stuff comes into micki@purehealth and most other stuff goes into enquiries@purehealth or a completely separate Gmail account. I have paid for Gmail for Business and that means I can give Christine (my supplement superwoman researcher assistant) her own Purehealth address – and anyone else I draft in to help ad hoc. It looks nice and professional. Christine et al sign off as Christine, Purehealth Team.

I have also overlaid the Sorted for Gmail app onto my Gmail account. This revolutionised my Inbox and it makes life SO much easier. If you’ve not come across it, have a good play with the free trial, and there’s a free forever plan if you don’t need all the fancy-shmancy stuff. 

Essentially, it takes all Gmail and sticks it into a more readable version, lets me put certain ones into special labels, but most importantly, gives me several columns that I can simply sweep emails into. For example, I have ACTION, HOLD, FOLLOW-UP, RESEARCH and any other specific project ones as needed, such as the name of the next book or factsheet I’m writing. You can then see exactly what you have to do first, find things easily when more info requested comes in, tick stuff off etc. I love it!

Have a gander at the video here and see if it might make your life easier. Trust me, if you’re a newbie, putting systems in place like this will really help later on as you get busier! In fact, having just watched that video myself, I realise it’s moved on a lot since I started using it about 7 years ago – I need to get myself even more sorted, I think! I do love tech; I can’t help it!


SPECIALISE OR GENERALISE?

Here’s another post I wrote – and, funnily enough, since I wrote it, I’ve been wondering about this in my own clinic life. Am I too general? Would like be easier if I specialised – I am the go-to gluten/grains gal in the UK already, maybe I should be capitalising on that, update myself and become a gluten specialist for this last decade or so in my clinic life. I’m musing… Meantime, here’s the post:

PRACTICE PEARL: WHAT SHOULD YOU FOCUS YOUR PRACTICE ON?

This is the perennial question, isn’t it? Should I stay a generalist, specialise in something, or do both?

There’s no right or wrong answer to that. I have ‘accidentally’ specialised in allergy/hypersensitivity/gluten related illness over time, but am a generalist at heart as I get so interested in everything! But, there is no question that specialising makes life a LOT easier, not least because you can focus yourself on a particular subject research- and CPD-wise and not get so overwhelmed, become an expert in that field, need only to know your supplements, testing, treatment protocols etc relating to that topic, and you can market more effectively to find those people who need you most in that specific niche.

Hey, maybe I should have specialised?!

OK, so whether you intend to be a generalist or a specialist, what are the best topics to focus on? Ooh, the $60 million question! Well, ask yourself what people are really having problems with? And, out of those, what are you really interested in? There’s your Venn diagram of your clinic, if you like! A juxtaposition of stuff that will keep you interested, challenged and will help the most people. That is a successful clinician.

To help, watch Prof Tim Spector’s video that I referenced earlier in the news digest. 6.44 minutes in, he shows a graph of the most commonly self-reported symptoms generally in the UK (non-Covid). For a clinician, that is dynamite info! Fatigue is top, followed by stress/anxiety. Go figure.

It’s a great list for you to focus your skills on. If you’re building your practice, I would copy that list, choose which topics really get your juices flowing, working from the top down, and then focus on those. Or, if you haven’t a clue, start to focus initially on fatigue – there are clearly so many people who need your help with it! Later, when you feel you’re on top of that, have built some resources, expertise and patient experience with that, either stick with it, expand to a different fatigue niche or then start adding stress/anxiety stuff.

If you want to be really clever, you would choose a very specific type of person to focus on in a topic. For example, with fatigue: women in menopause with fatigue, teenage chronic fatigue cases, men in mid-life with low androgen status, hypothyroid patients, post viral (Covid?) fatigue. Do you see?

Work up an outline of your target patient: how old are they, where do they live, what kind of social class are they, how educated, what paper do they read, what’s their favourite food etc etc? Imagine them in front of you; what do they need most? How can you help them best? What’s the best delivery mechanism for them specifically? Is it 1:1, group work, online resources? Don’t just be limited by your training and how others do things. Really think about what that person might need. How can you provide it? Can you do it alone, or are we looking at a team effort, a community response?

Fun! I wish I was starting again, lol. I hope that helps.


CLINICAL PEARL: CHEMICAL SENSITIVITY

Finally, here’s my favourite clinical pearl from the last 8 weeks for you. I’m repeating it because it’s unusual, very unknown, but could help so many of your really sensitive patients.

We all come across people who will react with a headache or some other symptom when they walk into a shop with those awful stinky, toxic candles, or when they walk into someone’s house with air fresheners, into a pub or cinema and someone’s perfume sets them off. I used to be terrible myself, and it ain’t fun!

Here’s a quick tip that will sometimes bring a reaction down very quickly. Not always, but it’s worth a go. Chew 3 Mo-Zyme tablets and see if the reactivity lessens. If it’s going to help, the person should feel better within about 30-45 minutes.

If it does help, it gives you a clue that the patient has a body overload of acetaldehyde because Molybdenum is needed to process that efficiently. If they don’t have enough Mo, the slightest exposure to smoke, perfumes, car fumes etc will likely tip them over the edge. Think: why is there a build up of acetaldehyde in the first place too – candida, poor detox genes?

There are lots of mechanisms involved in chemical sensitivity and MO is not going to sort it all out, I’m sure, but it can be a god-send for the patient and improve life if it helps them get out and about more, and an excellent patient clue for you. Hope it helps.

OK, so there’s the last issue for you. Hope you found something useful. If you’d like to support me, you can buy me a coffee here. Meantime, hasta la Vista, baby. Who said that recently? Oh yes, let’s just not go there…. !

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