Hello everyone, this is Dr. Hogue.
Last weekend I attended a course to learn Fascial Counterstrain (FCS). FCS is a manual therapy method that can be used to relax tissues of the muscles, bones, joints, ligaments, nerves, organs, lymph, veins, and even arteries. I attended the introductory course to see if the method was valid and have been using it since returning. So far I have seen some pretty impressive results.
FCS is a paradigm shift for me, allowing me to treat things with manual therapy which I never thought were possible. If you’re interested in learning more, come on in for a visit. You can also look forward to an upcoming post which explains the ideas and principles of the treatment in more detail.

While I have done my fair share of testing in the past, I have done very few in the past couple years despite it being a common request from new patients.

Any of you who have seen us here know that we are big fans of zinc for mental health, but it is extremely important for gut health as well. Not only does it heal the intestinal epithelium, but it also improves the microbial biome and digestive enzymes.

Metallothionein is a protein that lives in a bunch of places in our body, but the highest concentration is in the gastrointestinal tract. It is extremely important in the prevention or treatment of food sensitivities (not full-on anaphylaxis type allergies, that's a different issue). It helps to break down gluten, gliadin, casein, casomorphins, and other proline containing proteins. Which in layfolx terms is wheat and dairy. If you've noticed that you feel better when you avoid breads and cheeses, you may have a zinc deficiency.

It's also common to experience more sensitivities to food dyes and shellfish if your copper levels are too high. This is important because copper and zinc are paired minerals, and when the copper is very elevated, zinc is often very low. 

Metallothionein also helps to kill candida and keep other yeasts at bay, so if you've noticed a sensitivity to sugar and sweet foods, feeling more bloated, foggy headed, or experiencing diarrhea or constipation, then you could have a candida overgrowth that would improve with adequate zinc supplementation and possibly some additional antifungal compounds. And I never put anyone on the candida diet because it fixes nothing and just makes life really unpleasant.

So if you think you are sensitive to wheat and dairy in particular, you may want us to evaluate and treat your zinc levels. 

As a side note, I've never treated SIBO per se. I don't run the tests and I don't use the treatments, but I have extremely infrequently felt the need to send someone elsewhere to another doc who does this testing and treatment.  I did find a study that stated zinc levels were the sole independent predictor of SIBO in a specific population that was tested. Correlation does not imply causation, however this is an interesting area to consider for future studies. 

​Dr. Jen

Out with the old and in with the new!
2017 was a fantastically tumultuous year for us here at Avalon. Buying the business, but losing Dr. Haff, and adding to my therapeutic repertoire are just a few of the biggies that happened. This year will be more changes in store, I'm sure, but we'll keep you posted as they happen. 

I'm still looking for some new doctors to add to the staff, and have recently had some great applicants. Interviewing, vetting, negotiating, etc all need to happen before I commit to bringing someone into our happy home, but it's all in the works. 

If you've been in the office in the past few months, you know that Sandra from Mercy Diagnostics is here with us on Fridays. So if you need a blood draw from a fantastic, patient, and fun phlebotomist, schedule any blood draws with us for Friday. She's still at another location M-Th if you need a different day (ask for details). 

We also rented one of the offices to a wonderfully kind therapist by the name of John Powell. He's technically a separate business, so you need to contact him directly to schedule an appointment. And yes, he is taking new clients. 

I'm loving the results I get from the Walsh Research Institute protocols I've been using. The information I learned has revolutionized my practice and my success. I've also started to immerse myself in Body-positivity and the Health At Every Size Movement, which I feel is very in-line with all of the Naturopathic Principles. 

See below for some highlighted changes! 
​
Telemedicine is here!

Technically, it has been authorized for us to do telemedicine since October 1st, but since I was in the midst of purchasing the business, I kind of dropped the ball. And as I'm writing this, schools are closed due to frigid cold temperatures. Wouldn't it be great if you could meet with me via a virtual face-to-face HIPAA-compliant website? 

​You'll need internet access, and a device with a camera, but that's it. And, I'm only booking 15 or 30 minute slots, so if you feel like you need more time, then I'll need you to physically come to the office. I'm sure there will be a few bugs to work out along the way, so please be patient. 

Supplement Sale

We have a bunch of really great, high quality supplements that I do not tend to prescribe and, I'd like to make room for some new options. So, I'm giving you 50% off the supplements on the shelf closest to the hallway. Additional discounts do not apply, but if you see something you want, come get it. These are supplements I won't be replacing on our shelves in the future. 

 Click to see sale items

Expanding Availability

I will be expanding the available hours in which you can schedule with me at the end of February. Our overall schedule of 9-5 isn't changing, just how many patient-hours I have in a day. 

This week is Naturopathic Medicine Week, a week in which NDs try to inform people about what it is we do and why it's different from the conventional model.
 
I personally wanted to point out that NDs in Vermont have it better than NDs anywhere else in America.  I made a couple posts about it on Twitter, Instagram and Facebook.

The best part though, is that we get to live in Vermont, with the greatest patients in the country who already understand the importance of eating local and organic, who oftentimes are herbalists or know herbalists, who want to keep our environment clean, and who appreciate naturopathic medicine more than anywhere else from my experience. 

On to more practical matters, Tori is out until next Wednesday, so if you aren't getting the same great front office experience you normally get, it's because I'm not as good at it as she is. :)

I'm also extending the supplements sale until the end of the month. Not everyone checks here and our social media accounts, so I want to make sure that as many patients as possible have an opportunity to get the extra discount. 

Week one is over and things went pretty smoothly despite some behind-the-scenes hiccups. I've still been making slight adjustments to the decor and systems, so this is a summary of recent and future happenings. 

NECLA conference: Literally in the middle of Dr. Haff and I closing on the business, I left to go speak at UVM Medical Center for the Northeast Community Laboratory Alliance about the benefits and challenges of working with local Naturopathic Physicians. Attendees included management, customer service and phlebotomists from UVM and other regional hospitals. I love public speaking, and my hosts and the attendees were great. 

Social Media: I've started some new accounts and am trying to post in those places more often, rather than sending out infrequent emails. If you are a social media user, follow us on these platforms:

• Facebook - https://www.facebook.com/avalonnaturalmedicine/ 
• Instagram - https://www.instagram.com/avalonnaturalmedicine/
• Twitter - https://twitter.com/AvalonNatMed

Mercy Diagnostics: If you've been in the office in the past 8 months, I may have already recommended you use this phlebotomy site and laboratory at another doctor's office. This past Friday, we welcomed Sandra, the phlebotomist for Mercy, into my recently former office. She'll only be there on Fridays, since she is still at the other location Monday through Thursday, but if we get busy enough, Mercy will consider expanding the available days. 

Room changes: As I said above, Mercy Diagnostics is in my most recent office (for those of you who have been around long enough to remember that I used to be upstairs). Last weekend I moved into Dr. Haff's office, including moving around the furniture quite a bit. This weekend, I painted the red door and frame inside and out to match the new colors in the hallway and to visually cool down the office itself. ​

Tori will be going on vacation from the end of this week to the middle of next week, so you may not get the same quick response as she provides when she's here. I've cut down my patient load while she's gone so that I can be available for everything else. ​

Our supplement sale continues this week. 20% off all homeopathics, herbal tinctures and anything on the shelf closest to the hallway. If you've been holding off on getting something, now's the time to get it. If you need something that isn't on our shelves, we also have an online store through Fullscript at https://us.fullscript.com/welcome/avalonnaturalmedicine

It's been a busy week! My goal is to provide you with the same great level of care to which you are accustomed, while still continuing to improve. 

I've got two pieces of big news regarding supplements:

1. We now have an online store through a service called Fullscript. I have the prices set low for the time being to get everyone used to this new system. If you want to compare prices, you should see that they are similar or less than other sources. Check out OUR STORE HERE! 
2. Select in-office supplements will be marked down to 20% (or more in some cases) off the marked price for the next two weeks.  No additional discounts apply. Physician grade supplements, herbal tinctures and homeopathics are included as long as they are available. 

It's official! If you are interested in Walsh's Advanced Nutrient Therapy and are in Vermont, Quebec, Upstate New York, or potentially parts of New Hampshire, I'm your doc. I've been administering the protocols since I came back from the conference at the beginning of May, but this puts me on the WRI website so that people who are looking for this type of successful therapy, they can find me. 

If you're interested in William Walsh, PhD or his therapies that he developed alongside Carl Pfeiffer, MD, check out the website for the Walsh Research Institute.

We're in the home stretch here at Avalon Natural Medicine. Dr. Haff has seen her last patients and will be back next week for our final transition work.

I couldn't have asked for a better boss and its been pretty sweet being an employee only for the past 5 years. Thankfully, she's had all the systems in place for a fairly easy transition, and has been walking me through all the steps of what she does as the business owner. 

There will be some changes over the next few months as I put my own spin on this place. If you've been in lately, you'll have noticed some new paint, new shelves, etc. I'll try to keep the newsletters and emails to a minimum and notify you here, and repeating the same info on other social media outlets. So if you have one you like in particular, follow us so you can get the latest. 

​Three years ago I was dealing with my mom dying from cancer. It was rough, to say the least, but I feel like I’m in a better spot now and able to share some things that I wrote back then. This compilation of comments I made on my personal page is edited for vulgarities (I swear!) and clarity, but since the statements still feel so very true and real to me I left all wording in the present tense.

It’s hard to say this out loud, because I may come off as callous, but if one just looked at my news feed on a regular basis, you would assume that all people with cancer are beautiful bald women and children with tons of social support. But cancer is ugly, and not everyone has a large social network to throw benefits in their honor. There aren’t organizations to help depressed old smokers to make a wish come true before they die. And it’s not that I begrudge anyone’s celebration, I just want to remind everyone that cancer is ugly and lonely, and not everyone gets to walk away with a trophy.

I think it would be fantastic if people acknowledged those battling cancer who won’t be able to hold up a sign on Facebook saying that they beat it, or that it’s their last day of chemo, etc. Not everyone with cancer is a “survivor". Some quietly fight for their lives, regardless of how brief it may be, to spend just a few more days or months on this planet. And they deserve our attention too.

My point is that we glamorize beating cancer, rewarding the “winners” with notoriety, giving preferential attention to the visible. All while many are too sick to join a 5K or have their picture spread on the internet. Cancer is ugly and it kills. It kills nice people and mean people, people who lived life to the fullest and those who didn’t, people who changed their circumstances or risk factors and some who didn’t, some who took charge and fought and some who give up early on. I think it would be far more honest if our society acknowledged the ugliness of all cancer and made a concerted effort to not glamorize it.

Like I said before, this is difficult to say publicly because it sounds like I don’t care about people like the adorable twin with fantastic dimples all over my news feed at the moment. But that couldn’t be further from the truth. I care about him, my friends who have had cancer in the past that have beaten it, a best friend who is currently battling stage 4 melanoma, my mom battling stage 4 small cell carcinoma, my patients who come in frightened about a symptom that may be cancer, and so many others.

But what I see, is that I’m one of a few who is willing to talk about the ugly side. I see this inspirational stuff and it makes me annoyed and angry. We put pretty pictures on Facebook of people beating cancer because talking about the death and destruction that cancer causes to the person and to their families is uncomfortable. I once had to rebuild 2/3rds of a man’s face because of jaw cancer that left him dead and mangled after 17 surgeries. [For those of you who didn’t know, my first profession was an Embalmer.]

And it’s partly my fault because I don’t want to talk about how in the last 1-2 months my mom was hospitalized for pancreatitis, found out all of her brain tumors are back, went through another 2 weeks of whole head radiation, suffered a pulmonary embolism on the final day of radiation, was put on warfarin, puked so hard she fell out of bed and is now covered in bruises thanks to the warfarin. But I’ve had enough of the beautifying of cancer. I’m officially done. I’ve kept quiet for far too long and I’m now going to be that outspoken jerk.

I don’t think there is an easy way to deal with it, but I can tell you that watching my mom slip away in tiny pieces, day by day is awful. She’s not my mom, but she’s not dead, and I don’t know which is worse. I see the inevitable and I don’t want it to ever come, but part of me wishes I could just rip the bandaid off quickly so I don’’t have to watch her suffer and wither into a shadow of the woman who sacrificed her whole life to make mine better.

And to bring up another ugly aspect of cancer, I feel that we sympathize less for those who don’t live a pristine life, or decide to get all holistic when diagnosed, or those who choose not to do the conventional route, or those who are older instead of kids. We get kind of judgy when it comes to the most personal of decisions. I wasn’t the least bit surprised with my mom, and I don’t blame her for choosing the conventional route over what I had to offer. And her life isn’t worth any less to me because she smoked all those years. But I definitely feel (and maybe it’s just me) like people put out a she-got-what-she-deserved vibe.
​
No one deserves cancer. No one’s life is more valuable than others. No one deserves to feel guilty about how they choose to live their life. No one deserves condemnation during the hardest struggle they will ever endure. They just need our support. The ugly ones, the depressed ones, the ones too weak to get out of a chair much less walk a 5k.

Sometime before last Thanksgiving, I started dabbling in bread making. I wanted to make sure that it would be a habit that would stick with me, and it has, so I wanted to share my thoughts on the whole concept now that I have a couple loaves under my belt. 
First, I’m sure everyone wants to know why an ND would make bread. I am occasionally gluten free and a-whole-bunch-of-other-things free, but in my house I have one member who is gluten free and the other is corn free, so it pays to be flexible. The gluten free part is easy, I make a gluten free bread for my son. But for my nutritionally-challenged corn-free husband, things can get really complicated. 
Corn is in everything. Including bread. Corn syrup, corn starch, corn solids, corn meal. He is already very limited in what he can eat, or is willing to eat, so having a bread available to him makes all the difference. We did find a commercially available bread with no corn here in Vermont, but it has over 10 ingredients, which at any time might change. We are constantly re-checking ingredients lists for this reason and anything with a laundry list of ingredients is exhausting. Making something with only 4 ingredients (6 in the case of the gluten free bread) really appeals to the desire for my family to eat whole foods as much and as often as possible. 

But I’m a busy lady! I need something that is easy and doesn’t take a lot of time. Luckily, I’ve found all the things to make this happen on a regular basis and I’ll share it all with you. I’ll list all the resources and products that I use. I won’t have any links since this post is for informational purposes only. 

I originally used a recipe I found on Pinterest, but then when I needed more information, I bought a book called The New Artisan Bread in 5 Minutes a Day by Dr. Jeff Hertzberg and Zoe Francois. It has wheat and GF recipes, so it’s great for a mixed household like mine, but they have also written a completely gluten free cookbook as well. 

When I first started, I went by the recommendations to make a large batch and store it in the refrigerator. But, if your house is like mine, refrigerator space comes at a premium, so I started making one-loaf batches and keeping it on the counter most of the time. Except for the GF bread which I allow to rise on the counter, then store in the fridge until I’m ready to bake.

Ingredients for Wheat Bread:

• Water - 1 ½ cups hot tap water

• Salt - 1.5 teaspoons (0.5 Tablespoons)

• Yeast - 1.5 teaspoons (0.5 Tablespoons)

• All Purpose Flour - 3 ¼ cups 

The authors of the above book recommended memorizing a ratio so that it is easier to remember without constantly referencing the book. 6, 2, 2, 13 is the mnemonic that stands for 6 cups of water, 2 Tablespoons of yeast, 2 Tablespoons of salt and 13 cups of flour. As you can see above, my list is just ¼ of those numbers. 

The gluten free version is just as easy to remember. Switch out the All Purpose Wheat Flour for Bob’s Red Mill Gluten Free 1:1 Baking Flour. Add 2 whole eggs and ¼ cup of melted butter (for the ingredients listed above, multiply as needed for larger batches). Voila! The 1:1 flour works great without having to source a bunch of different individual ingredients to mix together for your own flour. Although, if you prefer to do it that way, the list of ingredients is in the book above. 

Directions:
Mix together the water, salt and yeast. In the case of the GF bread, also mix in the eggs and melted butter. Then add the flour. I prefer to keep my kitchen on the minimalist side, so instead of investing in a large blender or bread maker, I use a stainless steel mixing bowl and a Dough Whisk. After mixing everything together, I cover the bowl with a silicone suction lid. 

If you mix up the dough in the morning, it will be ready for baking in the evening, and vice versa. After a couple hours, I put the GF dough in the fridge to continue rising, but I leave the wheat dough on the counter for up to 1.5 days (usually when I need to bake a new loaf anyways, but if not, I’ll stick it in the fridge). You can store the dough in the fridge for up to two weeks, but I find it easier to mix a small batch every few days instead. 

The GF dough gets ladled into an oiled bread pan as it is not stretchy like the wheat dough. The wheat dough gets covered with more flour and cloaked, which means to gently fold the top and sides down and under to the dough ball. You will not knead either of these doughs. After you place them in the loaf pans, you should let them rest for 45 (room temp dough) to 90 minutes (refrigerated dough). Then place them in a 450 degree oven for 35-40 minutes. Pull them out and allow to cool on a rack before cutting into them. 

My last piece of advice is to have a great bread box and a good bread knife. I bought the Clean Dezign Bamboo Fiber Bread Box Bin with Cutting Board Lid and can’t believe how fresh it keeps my bread. For the knife, I have a
Victorinox 10.25 Inch Serrated Bread Knife with Fibrox Handle and I love how it cuts the bread with ease. 

Fresh bread, minimal ingredients, and easy enough to accomplish after work whenever we’re running low. The “5-Minute” portion of the book title is obviously in reference to prep time, not rising or cooking time, but you can do any other thing around the house while those happen so it isn’t included. 

*I have no affiliations with any of the brands listed here and receive no compensation from any of them.