Here’s your monthly Clinic Notes for practitioners. Couple of practice and case pearls for you this time, plus research and newsy bits. Hope you find something that helps your practice this issue.
PRACTICE PEARL: GETTING YOUR EMAILS SORTED
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 anyone else I take on their own Purehealth address. It looks nice and professional. When I had assistants, they signed off as X, 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. It is quite hard to keep under the limit of 50 email limit in the folders, I confess, but it’s good discipline to weed it out regularly when I go over the quota! (50 was the limit last time I looked, might be different now).
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, CLINIC, 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!
NEWS/RESEARCH BITS
Did you see the hoo-ha about Dr Bredesden recently? The NY Times wrote a pretty scathing article about his approach to Alzheimer’s and he has since written a reply/rebuttal. Such a shame to see yet another pioneer trying desperately to help a somewhat preventable and treatable chronic illness get shot down in flames. James Maskell wrote a piece about it below. You can see the original NY Times story here and DR (not Mr) Bredesen’s rebuttal here. It does make me sad. As Dr Bredesden is quoted as saying in the piece:
It amazes me how people fight back against something that’s actually helping…
Dr. Bredesen vs. The New York Times: Whose Model Is More Predictive?
I always rate the work Dr Rick Hanson does on mental health. This podcast on Living with (and treating) depression references anhedonia (the inability to feel joy or pleasure in life). I had a patient a while ago with this issue, which is why I keep my eye out for stuff on it. I’m also seeing a lot of menopausal and andropausal peeps who mention the same feeling.
They discuss “anhedonia, the catch-22 of treatment resistance, how to build new practices when it’s the last thing you want to do, acceptance, and how a values-based approach can help someone move forward even when they’re feeling stuck. The conversation touches on some of the existential aspects of depression, the therapeutic relationship, and finding some humor along the way.”
It seems that everyone is now writing on Substack. Forrest, Rick’s son, has a newsletter here, which might be worth a follow.
New study on nigella/black cumin oil improving oestrogen and vaginal tissue in menopausal women. Interestingly, nigella is also a great mast cell inhibitor. So, if you’ve got a menopausal woman who has become more sensitive to stuff too – which happens a lot IMCE (in my clinical experience), that could be a good double-whammy choice. I just made IMCE up; I rather like it!
Actually whilst I was just looking for a reference for you on nigella’s mast cell actions, I came across this useful article on herbals for histamine and mast cells. Could be useful. Long story short: fave herbs are: perilla, baical skullcap, nigella and nettle leaf. But read the full piece if you have time, some useful tips in there. I’ve added a few learnings to my forthcoming MCAS factsheet – if I ever get it finished!!
CASE PEARL: CHEMICAL SENSITIVITY
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 (Yankee, I’m looking at you!), 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!
In fact, as I was typing that last sentence, a delivery man just delivered some cat litter. He literally came into the porch, dumped it and left. It STINKS of strong aftershave or deodorant in there from just those few seconds. Honestly!
Anyway, back to the point of this piece…
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.
And finally…Couple of quotes from James Clear resonated with me this week. The first is wise advice and, hopefully, confidence-boosting if you’re a newbie:
“Treat failure like a scientist.
Each attempt is an experiment. Each mistake is a clue.
You’re not failing. You’re refining.”
I actually enjoy that process of discovery in a complex case, but I know it can really feel like failure if your confidence and clinical experience is on the lower side. The trick, I have found, is to always set expectations well with your patients. I always say they are the expert in their own body and our job, together, is to try and find the clues and follow them. We won’t always get it right, but we’ll always be moving forward. Something like that. It’s the truth. Nutritional therapy is an art as much as it is a science and we have to be open to learning. The combined knowledge between patient and physician is synergistically MUCH stronger than either on its own. Ooh. I sound quite profound there 😉
And the next quote is equally useful. I am wondering whether to specialise in something at this stage myself. Being a generalist is fun and fascinating but I’m sure my almost-60 year old brain might like a less massive field of subjects to focus on!
“One way to stand out is to look for pockets of low competition.
Wake up early—less traffic, fewer people.
Go deeper or narrower in your field—less noise, more space.
People are drawn to where it is crowded. Look for the quiet spaces inside your areas of interest. Excellence often hides at the edges.”
For a start, it’s MUCH easier to market yourself in a niche than try to be everything for everyone. It makes me laugh that I say that as I’ve done that very thing – and, I have to say, loved every minute of it! Specialism ideas on a postcard…?
That’s it for this issue, folks!
I truly hope you find Clinic Notes useful. If you like what I’m doing, please support my work by subscribing here. Bless your cotton socks for helping and thank you from everyone who benefits, Micki x