Coronavirus – Update 03/15/20


(This is an update to my post from 5 days ago, which you can find here:  drlorrainecaron.com/wpblog/2020/03/10/coronavirus-march-10-2020/ )

 

As I mentioned last time, I have been getting messages from patients concerned about the current coronavirus pandemic (COVID-19) who would like me to share my perspective, so here it is.  THIS IS NOT INDIVIDUAL MEDICAL ADVICE, just my take on things.  If you are my patient, give me a call.  And you can find up to date medical information about this illness on the WHO website, the CDC website, as well as your state and local health department websites:

https://www.who.int/emergencies/diseases/novel-coronavirus-2019

https://www.cdc.gov/coronavirus/2019-ncov/index.html

https://www.colorado.gov/pacific/cdphe/2019-novel-coronavirus

https://www.larimer.org/health/communicable-disease/coronavirus-covid-19

 

What (else) we know so far:

(First I want to clarify my Spanish flu/H1N1 statement from my last post.  BOTH the 1918 epidemic as well as the Swine flu epidemic were due to H1N1 influenza.  H1N1 is a strain of influenza type A.  I see now that the way I phrased it was confusing.)

It has become clear that exposed-but-apparently-well people can spread the virus for several days (3-4 is what I’m hearing) before symptoms start.  This makes voluntary social distancing imperative for preventing spread.

We have new research suggesting that COVID-19 may last in the air for 3 hours or so.

At this point, anyone who can be staying at home or away from others SHOULD be.  Your most vital duty is to help slow the spread so that our intensive care units don’t go beyond maximum capacity at any given point in time.  When this happens, doctors have to start deciding who to save.  Nobody wants that.

You may have heard the term “Flatten the Curve” – here is a great resource for learning about this idea:   https://www.washingtonpost.com/graphics/2020/world/corona-simulator/

And a more technical and in-depth resource:  https://www.flattenthecurve.com/

While it is still true that the elderly and those with underlying health conditions are at higher risk of death from COVID-19, it’s looking like around half of people in ICUs with the virus are under 60 years old.

Most common symptoms are still fever and dry cough.  Some doctors are reporting more headaches and sore throat too.  Runny nose and sneezing seems to be rare.

I’m also reading that some patients who have more severe disease but survive may still be left with some level of lung fibrosis.  This is different from influenza, and we should be taking it seriously, even those at lower risk.

Poudre School District and Thompson School District, like many other Colorado districts, have closed school for the next two weeks and will be reassessing as time goes on.

Governor Polis has closed all ski areas indefinitely.

 

Updated Recommendations:

General:

If you have a fever and a cough, the current recommendation is to call your primary care physician first.  If you don’t have a PCP, call the hospital or health department.  A doctor will decide whether you might fit the criteria for testing, and let you know where to go.

We do have a drive-up testing station in the Denver area now (check https://www.colorado.gov/pacific/cdphe/covid-19-testing for location and times).  You’ll need a doctor’s order for the test, or there will be someone onsite to assess you.

If you are having trouble breathing, go to the emergency room, but call ahead to let them know you’re coming so that they can do your intake safely.

The CDC is still recommending that all people over the age of 60 and anybody with underlying health conditions self-quarantine at home as much as possible.  Consider online shopping and telemedicine visits where possible.

Prepare for the possibility of needing to self-quarantine by having a 2-3 week supply of food, pet supplies, toiletries, paper goods, and medicines.  Stores and pharmacies will remain open, so there is no need to hoard supplies.  Simply try to limit the need to go shopping.

 

Hygiene:

These recommendations remain the same:

Wash hands with soap and water for 20 seconds – of course after using the restroom, but also before you leave the house and as soon as you get home.

If soap and water isn’t available, hand sanitizer with minimum 60% alcohol is second best.

Try not to touch your eyes, mouth, or nose with your hands.  This helps prevent you from putting your germs on other people or public surfaces, and also prevents you from transferring germs from surfaces to your mucous membranes.

Don’t shake hands.  Wave, elbow bump, get creative!

 

Continue to support healthy immune function:

***There is some early indication that anti-inflammatories, including ibuprofen, may worsen the course of this disease.  Therefore, acetaminophen (Tylenol) may be preferred.  Still keeping an eye out for confirmation on this.

If acetaminophen is used, my recommendation is to add n-acetyl cysteine (NAC) to the immune protocol to compensate for its glutathione-depleting effect.  NAC is a mucus-thinning supplement also, so it’s often a part of respiratory support anyway.

As in any acute infection, if the fever is manageable with comfort measures like hydrotherapy and distraction, it is preferred not to suppress the fever at all.

Responding to confusion around Elderberry and the cytokine storm issue, the relative consensus among NDs and herbalists that I’ve seen, based on both clinical experience as well as research, is that this worry is a non-issue.  Influenza,  strep, and other infections can induce cytokine storm, as can COVID-19, but elderberry has not been known to aggravate or induce it in these illnesses.  There’s no expectation that it will in this one.  If you’re itching for research citations, I can get some to you.

Green tea may be a good addition to the immune arsenal, as research shows it has antiviral activity against a range of viruses.  One citation to get you started:   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6222519/

 

Homeopathy:

For those using homeopathy, the remedies mentioned last time were coming more from homeopaths abroad.  Now we have more info shared by US homeopaths, who have added some remedies to the mix – Sulphur, Lycopodium, Phosphorus, Arsenicum, and Bryonia (like the previous recommendations.)

 

So again, there’s no need for panic, but we should be preparing for an increase in illness in our community.  The very best things we can do are to distance ourselves physically from others, wash our hands diligently and often, and check in on the vulnerable members of our community.  Help flatten that curve!  If you get sick but you are okay, stay at home or call your doctor’s office.  If you think you may have COVID-19, call your doctor or call ahead before going to the hospital.  If you have to go shopping, be kind to the checkers.  Give extra love and support to the healthcare workers in your life, because a lot of them are on the front line.  Take care of yourself in this time of high anxiety and isolation.  And let’s take care of each other.

Dr. Caron

 

P.S. For my patients…given the situation, I am postponing in-person patient visits at least two weeks, or moving to phone visits as possible/desired.  I’ll be keeping an eye on our local situation to decide whether I’ll be seeing patients in person beyond that time.  I’ll be calling currently scheduled patients tomorrow to reschedule.  I appreciate everyone’s flexibility in this unique time.

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Coronavirus – March 10, 2020


I have been getting messages from patients concerned about the current coronavirus pandemic (COVID-19) who would like me to share my perspective, so here it is.  THIS IS NOT INDIVIDUAL MEDICAL ADVICE, just my take on things.  If you are my patient, give me a call.  And you can find up to date medical information about this illness on the WHO website, the CDC website, as well as your local health department website.

https://www.who.int/emergencies/diseases/novel-coronavirus-2019

https://www.cdc.gov/coronavirus/2019-ncov/index.html

https://www.larimer.org/health/communicable-disease/coronavirus-covid-19

 

What we know so far:

There is little immunity worldwide to this strain of coronavirus which means that most, if not all, of those exposed will probably catch it.

(Other strains include several which cause common cold symptoms,  and SARS and MERS, which can cause severe respiratory symptoms.  COVID-19 is considered a SARS-type coronavirus.)

The incubation period is 1-14 days, with 5 days being most common (time from being exposed to when symptoms show up).

Unlike influenza, this virus seems to develop symptoms over days to a week.  Which means a person may be sick with milder symptoms for a while before serious breathing symptoms start.

There is community spread now, in general, which means you may catch it from someone who has not been out of the country recently, and who may not even know that they have been exposed.  In fact, it appears COVID-19 IS in our area.  A 50 year old woman with pneumonia has tested positive in Larimer County and is waiting on confirmation from the CDC.  In an abundance of caution, I would assume that it is spreading here.

Approximately 80% of those who get this illness will either have no symptoms or will have mild symptoms.  20% will have more a more serious course and need hospitalization.

Our best current estimate of COVID-19 death rate is somewhere between 0.6%-3.4% (general population), but the death rate in China so far for those over 80 years of age may exceed 20% and there is increased risk of death in those over age 50, smokers, and those with underlying health issues like asthma, heart disease, and diabetes.

Children have a much lower risk than adults.  As of now, no children under age 9 have died.  It seems they do catch the virus, and do spread it, but typically show minimal symptoms.

There’s no current indication that summer weather will impact the spread, as the southern hemisphere has cases, however, past viral epidemics have shown a seasonal pattern, so it’s still possible.  In the 1918 Spanish flu (H1N1) epidemic, for example, there was a milder spring outbreak followed by a severe fall outbreak.

Spread is primarily through droplets (cough and sneeze) and touch, which includes surfaces.  The virus may last more than a week on surfaces.  There are indications it is likely spread by the fecal-oral route also.

Handwashing with soap (any kind) and water for 20 seconds reduces spread.

If you don’t have access to soap and water, hand sanitizer with at least 60% alcohol content is second best.

COVID-19 primary symptoms are fever, fatigue, body aches, and cough – the virus seems to preferentially infect lung cells and the majority of patients won’t experience nasal/sinus symptoms or GI symptoms (diarrhea, nausea, vomiting), although these symptoms are more common in children.

There most likely will be no vaccine approved for general use for this virus for at least a year.

 

Recommendations:

General:

If you have a fever and a cough, your best bet for getting tested is at your local hospital.  Call ahead to let them know you’re coming so that they can take appropriate safety measures.

The CDC is now recommending that all people over the age of 60 and anybody with underlying health conditions self-quarantine at home as much as possible.  Consider online shopping and telemedicine visits where possible.  Regardless of age, I would avoid large groups of people when possible.

Those of us who are able to self-isolate and prepare will make it easier for those who can’t, such as health care workers, those without paid time off, and low income people.  Slowing the spread lessens the impact on healthcare facilities.

If you are younger and healthy, check in with your friends, family, and neighbors who are at higher risk to make sure they have what they need.

Prepare for school closures and the possibility of needing to self-quarantine by having a 2-3 week supply of food, pet supplies, toiletries, paper goods, and medicines.

 

Hygiene:

Wash hands with soap and water for 20 seconds – of course after using the restroom, but also before you leave the house and as soon as you get home.

Try not to touch your eyes, mouth, or nose with your hands.  This helps prevent you from putting your germs on other people or public surfaces, and also prevents you from transferring germs from surfaces to your mucus membranes.

Don’t shake hands.  Wave, elbow bump, get creative!

 

Support your immune system so that you are in the best position to handle any illness:

Get plenty of sleep and rest – sleep deprivation suppresses immune function

Don’t overdo your workouts – overtraining can also suppress immune function

Get fresh air

Stay hydrated

If possible, humidify your home/office – recent research suggests around 40% humidity is ideal for minimizing infectious spread

Eat nutritious food and minimize sugar, alcohol, and junk food.

Antioxidants such as vitamin C, vitamin A, selenium, and zinc have all been shown to reduce the risk of viral illness and/or reduce symptom severity.  Talk with your doctor about the right doses for you.

Vitamin D is essential for proper immune function and may decrease the risk of viral illness.  Consider getting tested.

Elderberry has been shown to reduce the incidence of influenza infection, and to shorten the course of infection in both adults and children – by up to 3-4 days.  We don’t know the effect on coronavirus yet, but it is a very safe herb for adults and children when dosed appropriately.  (High doses may cause nausea or diarrhea.)  Don’t use honey preparations in infants under a year old. Sambucol is the brand generally used in studies.

Many other foods and herbs have immune supportive and/or antiviral activity in general, including garlic, astragalus, nettles, and several species of mushroom.

There is a study in progress on using quercetin (a bioflavonoid in apples, onions, and other foods) in higher doses to treat COVID-19, so this may be a consideration in older children and adults.

 

Homeopathy:

For those who use homeopathy, the main remedies that seem to be helpful in this outbreak according to homeopaths who have been working in current epidemic areas are Gelsemium, Bryonia, Mercurius, and Eupatorium.  A common recommendation is to use Gelsemium 30c once a week if not in an outbreak area, Gelsemium 30c once a day for 7 days if in a local outbreak area, and the appropriate remedy if you do get sick.

 

In short, there’s no need for panic, but we should be preparing for an increase in illness in our community.  The very best things we can do are to be prepared to stay at home, wash our hands diligently and often, minimize unnecessary contact with others, and check in on the vulnerable members of our community.  If you get sick but you are okay, stay at home or call your doctor’s office.  If you think you may have coronavirus, call your doctor or call ahead before going to the hospital.  Let’s take care of each other.

Dr. Caron

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Toy Shopping for Healthy and Happy Kids


Artist at WorkWhen you’ve got holidays or birthdays and you’ve got kids, you probably have TOYS! Watching my children open their presents is one of my favorite things, but figuring out what to give them can be a challenge. Added to the dilemma of figuring out what they want, what I think is appropriate and what they will get the most enjoyment and use out of is the worry about what is safe. I’ve compiled several great resources to help parents navigate the issues and the gift-choosing process.

According to the U.S. Public Interest Research Group (U.S. PIRG), around 20 children in the U.S. die each year from toy-related injuries and about half of those deaths are from choking on small parts, small balls and balloons. A good test to use to see if a toy presents a choking hazard to a child up to age 6 is whether it fits inside a toilet paper roll. According to the Consumer Product Safety Commission, non-motorized scooters are the leading cause of toy-related injuries in children under 15.

U.S. PIRG has a good list of tips for avoiding dangerous toys. My favorite:

  • “New, powerful small magnets used in most magnetic building toys, toy darts, magnetic jewelry, and other toys can fall out of small toys and look like shiny candy. If a child swallows more than one magnet, the magnets can attract each other in the body (in the stomach and intestines) and cause life-threatening complications. If a child swallows even one magnet, seek immediate medical attention.”

U.S. PIRG’s full 2011 Trouble In Toyland report is here, including Appendix A, which has images of problem toys.

These days, parents need to be concerned not only about toys that might hurt children, but also about products which might be toxic to their health. Some children’s products have been found to contain hormone disruptors like pthalates and toxic metals like lead and cadmium.

Healthy Child Healthy World (HCHW) has Quick Tips for buying toys that are better for kids and the environment. My favorite:

  • “Is the toy re-useable? Can it be added-to, creating new interest? For example, doll houses and building sets get repeated use, and adding one small accessory at a time can bring much joy.”

HCHW also has more tips for finding environmentally friendly toys on their blog. My favorite:

  • “Ensure that children wear helmets when riding bicycles, skateboards, and scooters.” (Especially important considering all those scooter injuries.)

Here is my favorite idea from Consumer Reports‘ toy shopping safety tips:

  • “Do not buy metal jewelry — especially cheap metal jewelry — for young children.  About 20 percent of children’s metal jewelry has high levels of lead lurking beneath the surface coating.  A child who mouths or accidentally swallows a piece of lead-laden jewelry can suffer lead poisoning.” (High levels of cadmium are often found in cheap jewelry as well.)

The Environmental Working Group’s safe gift shopping tips are on their blog. My favorite tip:

  • Give activities, not things. Take your child to a play or a favorite restaurant, or sign her up for that gymnastics class. Time together and special activities make wonderful, non-toxic gifts!

My favorite tip from the Food Matters blog’s list is:

  • “Go au natural. Look for toys made of natural materials like solid woods (with no finish or a non-toxic finish) and organic textiles (cotton, wool, felt, etc).”

In that same vein, Jonathan Liu at the GeekDad blog has the ultimate, time-tested, economical kid toy list. As he says in the intro: “All five should fit easily within any budget, and are appropriate for a wide age range so you get the most play out of each one. These are time-tested and kid-approved! And as a bonus, these five can be combined for extra-super-happy-fun-time.” Enjoy this silly (but accurate) take on what kids like to play with.

And one final resource is HealthyStuff.org‘s product search, which includes test results for over 8,300 products consisting of over 20,000 individual samples. Here you can look up a children’s product if you aren’t sure about its toxicity.

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Get Ready for Flu Season


With the cooler weather comes falling leaves, family holidays and unfortunately, cold and flu season. Symptoms of the flu may include fever, chills, coughing, sore throat, runny or stuffy nose, headaches, body aches and fatigue. Vomiting and diarrhea are more common in children than adults and not everyone with flu will have a fever.

Conventional recommendations include prevention with vaccines, rest and clear fluids at home once you are sick and, in severe cases, hospitalization. Several recent meta-analyses of the research have raised questions about the effectiveness of flu vaccines. The current research shows little effectiveness of flu vaccines in preventing flu in healthy children under age 2. Research in the elderly is lacking. In healthy adults age 16-65, in an average flu season, 100 people have to be vaccinated to prevent one case of the flu.

The good news is that there are natural ways to prevent getting the flu and to feel better more quickly if you do get sick. Managing your stress, sleeping well, and eating a nutritious diet help you maintain a strong immune system. They are the foundation for wellness. You can also take a high-quality probiotic, black elderberry extract, vitamin C and vitamin D3 during cold and flu season. All of these supplements have been shown to help in preventing flu and shortening the time you are sick. Your naturopathic doctor might also recommend specific homeopathic remedies, or at-home hydrotherapy treatments, such as warming socks.

Handwashing and other good hygiene habits can help prevent the spread of flu to other people. If you are sick, don’t just take medicine so you can go to work or school! Stay home and get well – and save someone else the trouble of being sick. Once you’ve been fever-free for 24 hours, you are generally well enough to go out.

With a few good lifestyle choices, some healthy habits, and a few natural remedies, winter can be a time to enjoy friends and family, and not a time to worry about getting the flu!

Helpful links:

 

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Healing Broths


If you were going to add one thing into your diet, my pick would be broth!  There are many kinds of broth and recipe variations.  Broths provide nutrition that is easy for your body to digest.

The first two broths I’ll share with you are ideal for cleansing and detoxifying, especially during acute illness, giving the digestive system a rest.  The third recipe, bone broth, is ideal for supporting the bones, connective tissues, hair and nails.

Each of these recipes will increase the mineral content of your soups or stews, as well as add delicious flavor.  Prepare broth ahead of time so that you always have this nutrition booster to add to your meals!

Bieler Broth:

VEGETABLES NEEDED:

  • 2 medium zucchini
  • 2 stalks celery
  • 1 clove of garlic
  • 1 cup green beans
  • chopped parsley

Chop 2 medium zucchini, 1 cup of green beans, and 2 stalks of celery into a steamer and steam until soft (about 10 minutes).  Place steamed veggies, 3 cups of steaming water, and a handful of chopped parsley in a blender and blend until smooth (about 1-2 minutes).  If you like garlic, a clove or two may be added as you blend to help stimulate the immune system.

YIELD: 2-3 bowls


Alkaline Broth:

VEGETABLES NEEDED:

  • 2 potatoes
  • 1 cup chopped carrots
  • 1 cup chopped celery (leaves and all)
  • 1 cup of other available vegetable of choice

Use a stainless steel or enameled earthenware bowl.  Fill it with 1-1/2 quarts of water.  Do not peel vegetables, just brush them well.  Cayenne, pepper, basil, oregano, and other seasonings may be used as desired.  Cover and cook slowly for at least ½ hour.  Let stand another ½ hour; cool until warm, strain and drink only the broth.

YIELD: 5-6 bowls


Bone Broth:

INGREDIENTS:

  • 4 quarts of filtered water
  • 1.5- 2 lbs of beef knuckle bones (or any other kinds of meaty                                 bones or marrow bones – chicken necks work well)
  • Cloves from 1 whole head of fresh garlic, peeled & smashed
  • 2 Tbsp apple cider vinegar (organic, unfiltered)
  • 1 tsp unrefined sea salt

If you choose, you may brown or roast the bones/meaty bones first (in a separate pan/pot if using a slow cooker) with bacon fat or coconut oil before putting them into the water. Place all ingredients in a 6 quart crockpot and set the heat to HIGH.  Bring the stock to a boil, then reduce the heat setting to LOW.  Allow the stock to cook for a minimim of 8 hours and up to 24 hours. The longer it cooks the better!  Turn off the crockpot and allow the stock to cool.  Strain the stock through a fine mesh metal strainer and throw away what you skim off.  Place the cooled stock into glass jars for storage in the fridge (for up to a few days) or freezer for later use.

YIELD: 6-8 bowls

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Sleep Sweet (and Healthy!)


We’re in the process of buying a new mattress for our five year-old.  When our oldest was three, we began the journey of finding a good mattress.  Since then, that crib-sized mattress has been passed down twice, our oldest has gotten a twin mattress and we bought ourselves a new queen-sized one.  Now it’s time for our second to have his “big boy bed”.  We’ve learned a lot about healthy sleep on our journey and I thought I’d share some of it with you.

Adults spend about a quarter of their time sleeping.  For children, it’s more like a third to a half.  Not only that, the entire time is spent breathing the air right next to the mattress and bedding.  It only makes sense to keep that air clean and non-toxic.

A typical mattress is a chemical soup of glues, foam, pvc, and let’s not forget flame retardants.  For a discussion of the toxicity of flame retardants to humans (especially babies and toddlers who have a higher body burden), as well as their minimal effect on fire deaths, check out this article.  There is even some evidence that flame retardants and other chemicals may contribute to Sudden Infant Death Syndrome (SIDS), although this theory has been difficult to prove conclusively.

As a naturally-minded person, it doesn’t take much for me to choose a non-toxic product over a toxic one, but when it comes to my kids, there simply is no choice.  Until our regulatory bodies rule according to the precautionary principle, we’ll have to do it for ourselves the best we can.

So.  When it comes to natural mattresses, there are several things to consider.  These days, most natural mattress companies choose organic cotton for the fabric covering as well as the fill (in an innerspring mattress).  Organic means that you don’t have to worry about pesticide residue in the fabric.

You can also choose a waterproof organic cotton cover, which can be nice for younger children.  The waterproofing is made from polyethylene, which is a food-grade plastic that doesn’t off-gas.  I’m torn on the idea of plastic, but I definitely understand the benefit of waterproofing a kid’s mattress!

You also have the choice between natural latex (Dunlop or Talalay have different densities), innerspring, and natural memory foam (this was a new and intriguing one to me).  Latex is heavier, but much more durable.  Innerspring is lighter and generally less expensive, but will compress within 10 years or so.  The memory foam strives for greater comfort and is one of the more pricey choices.

And what about that tricky flame retardant issue?  There are choices there too.  Some companies choose to treat their mattresses with boric acid, which meets the standard, but may be harmful to developing tissues, the lungs, and the reproductive system.  That new memory foam company actually uses Kevlar as its fire retardant material.  You can also get a doctor’s note and have your mattress made without any flame retardant at all.  As it turns out, though, wrapping a mattress in wool renders it flame resistant and this is what many companies choose to do.

The first time around, we chose a Vivetique innerspring crib mattress.  We’ve used it for seven years, through three children, and it has held up marvelously.

When we bought our older daughter’s twin and our queen, we got them at the same time from a local store, The Natural Sleep Store.  You can’t beat buying from a local business and their customer service is wonderful.  The mattresses are both organic cotton/wool innersprings.  I suggest going for a less-firm mattress or getting a mattress topper, as they are pretty firm, but we’ve been very happy with them for the last three years.

Now we’re on the hunt again.  We may go with the Natural Sleep Store again, or we may choose one of the on-line retailers, some of whom are less expensive or are running specials.  Here are a few I’ve found:  (I should mention that I’m not affiliated in any way with any of the companies in this article.)

http://www.totsnstyle.com/proddetail.php?prod=naturepedicnorganiccottontwinultra

http://www.naturepedic.com/products/mattresses/ultra_organic_twin_full_mattress.php

http://www.greenmattressfactory.com/organic-eco-coil-pricing.html

http://www.daxstores.com/v-snq-ow51033.html

Have you used a natural mattress?  What is your experience?

Sleep sweet!

sleepy kid

He doesn't always make it to the bed!

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Egg Allergy


chicken eggs

Eggs

Hen egg allergy is one of the most common food allergies.  It is the second most common food allergy in children, although about 50% of these children will outgrow the allergy by the time they are an adult.  Fortunately, resources for people with food allergies are becoming more abundant, but it can still be overwhelming trying to figure out what to eat if you or your child are newly diagnosed.  Here are some suggestions to get you started.

First of all, if the allergy is life-threatening (anaphylactic), then eggs should be kept out of your house.  Teachers, other parents, coworkers, etc. should be notified and aware, and the allergic person should carry an EpiPen and know how to use it.  (EpiPen is a prescription medication.)  If the EpiPen is used, the person should then go to the emergency room or urgent care to be monitored.

If the allergy is not life-threatening, check with your doctor about a trial of duck eggs.  Some people with hen egg allergy are not allergic to duck eggs.

If the allergy is not life-threatening, and you have hen eggs in the house, wash your utensils and pots and pans thoroughly after cooking eggs, to prevent cross-contamination.

Make reading ingredients a habit. Egg is one of the “food allergy big eight” and is required to be labeled if it is an ingredient in any food product.  Of course, bad things happen, but if any egg-derived ingredient is in there, it legally should be labeled.

Going to restaurants can be a challenge.  Make asking about ingredients a habit.  TELL the server that you (or your child) are allergic to eggs and that it is important that you are not exposed.  With a life-threatening allergy, it’s better not to go to restaurants that serve any egg at all, because of the risk of cross-contamination.  If the allergy is not life-threatening, ask about ingredients before you order.  Also, remember that many baked goods (cookies, cakes, etc.) contain egg, as do some kinds of pasta, ice cream, and some sauces and beverages (for example, egg nog and Orange Julius).

Get in the habit of bringing safe foods to pot-lucks, sleepovers, and other special functions.  This is especially helpful for children.  If an allergic child is going to a birthday party, make some egg-free cupcakes ahead of time for the child to bring with them, and consider sending along some egg-free ice cream as well.

Breakfast can be another challenge, but there are many ways to get protein at breakfast without eggs – yogurt, smoothies made with yogurt or protein powder, sausage, nuts, nut butters (like almond or peanut), or just “eating dinner for breakfast.”  Leftover dinner meals can work well as a reheated breakfast.

Here are some egg substitutes. Each one is a substitute for one egg.  Some will work better in certain recipes than others, and none will work well if the recipe calls for more than 3 eggs:

  • 1 teaspoon yeast dissolved in ¼ cup warm water
  • 1 teaspoon baking powder + 1 tablespoon liquid + 1 tablespoon vinegar
  • 1½ tablespoons water + 1½ tablespoons oil + 1 teaspoon baking powder
  • 1 packet gelatin + 2 tablespoons warm water (don’t mix until ready to use)
  • 1 tablespoon pureed fruit such as apricots or bananas
  • 1 tablespoon ground flax seeds (flax meal) + 3 tablespoons water

For cakes and cupcakes, the flax seeds work pretty well, though if it’s a vanilla cake, it might affect the taste a bit.  It doesn’t change the flavor of chocolate cake at all.  Chocolate hides a lot of sins.  ;)

A helpful cookbook is The Allergy Self-Help Cookbook – My family loves the “Grain-Free Pancakes,” which are also egg-free.

A final quick tip:  if a food says “vegan”, then it will be egg-free.

Starting an egg-free diet can be difficult at first, but it’s worth it when you or your child feel so much better!

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Natural Care for Painful Ears


It’s cold and flu season again, and that means it’s ear infection season too.  3/4 of the patients I’ve seen this week have had a sore ear, some for the first time, and some as an ongoing complaint.  Treating a painful ear at home is often simple and effective – it’s just a matter of knowing why the ear is sore, and when it’s safe to self-treat.  Since about two thirds of acute ear infections resolve without any treatment, this is often!

Most adults and older children will recognize when they have a middle ear infection.  The ear feels full and painful.  With a younger child or nonverbal adult, you’ll generally see signs such as a red ear, crying or screaming, fever, tugging at the ear or digging in the canal, or non-wax discharge from the ear.  Acute middle ear infections usually come on with a cold or follow closely afterward.

The first thing to do when someone has a painful ear is to look inside to see what is going on.  Sometimes the infection is actually in the canal (otitis externa), rather than behind the eardrum (otitis media).  (This article doesn’t cover therapies for otitis externa.)  Sometimes in an intense infection, the eardrum will rupture.  Unfortunately, it so often happens that the pain comes on in the evening or in the middle of the night.  In this situation, it’s important not to put any medications INTO the ear canal until someone can take a look inside.  If you feel comfortable using a home otoscope, you can look in there yourself, otherwise call your favorite ND.  Laughing

Parents often wonder if their baby or toddler is just teething.  In my experience, if tugging or poking at the ear is the only sign, there is no fever, no screaming, no discharge, and no red ear, and there’s a lot of drooling or biting, then teething is the more likely culprit.  If any of the other ear signs are present, though, it’s important to check for an infection.

If you haven’t looked in the ear, there are still things you can do to ease pain and support the immune response, including homeopathy and hydrotherapy

Homeopathy is very effective for ear infections.  Two to three doses of a 30c potency (available at your local health foods store) will usually do the trick, when you get the right remedy.  Several common remedies for earaches include the following:

  • For a child or adult with a terribly painful ear that starts around 9 or 10pm, who won’t let you even think about touching the ear (except maybe with a warm cloth), and wants to be carried or held even though they are irritable and demanding, think Chamomilla, especially if one cheek is red and the other is pale.
  • If the earache comes on at night, there’s an associated sore throat, drooling and sick-smelling sweat, think Mercurius, especially with yellow-green discharge from the ear.
  • The most frequent remedy for ear infections, both acute and chronic, is Pulsatilla.  The person needing this remedy is weepy and wants to be held tenderly and given lots of affection.  It’s often the left ear that is most affected, with a painful full or bursting feeling.  It is worse with heat and better in the open/cool air.
  • In a person with a very high fever, red, hot face, cold hands and feet, and an unbearably painful ear (especially the right side), think of Belladonna.  The pains throb, tend to come on around 3pm or after midnight, and are worse with being bumped.  This person may be delirious with fever.

A good book for homeopathic self-treatment is Homeopathic Self-Care: The Quick & Easy Guide for the Whole Family.  If the remedy isn’t having any effect after three doses, stop.  If you are having difficulty finding the right remedy, call your ND or homeopath for help.

Two simple hydrotherapy treatments for an ear infection are the onion poultice and warming socks.

  • To make an onion poultice, thinly slice an onion and sauté in a small amount of distilled or filtered water until the onions are transparent (clear).  If all you have is tap water, that’s okay.  Place the sautéed onion into a cotton cloth (a flat-fold diaper works well) and gather the loose fabric.  This is where you will hold it.  Make sure the poultice is not burning hot before you apply it over the entire outer ear.  Leave it on until it cools and then gently dry the area and go to bed.  For a stronger treatment, make two poultices and do the second as soon as the first cools.  This treatment helps the pain and is antimicrobial.
  • The warming sock treatment is useful in any cold, ear infection or sore throat.  It increases the circulation of blood and stimulates immune activity.  The most important part is to be WARM before you start.  Take a warm bath first if there is no significant fever.  Next, take a pair of thin cotton socks and soak them.  Wring them out as much as possible and then apply them to warm feet.  Cover each entire sock with a wool or fleece sock and go to bed.  Kids will often want to take them off at first, but a few minutes of distraction usually gets them to the more comfortable part.  In the morning, the socks will be dry and the feet will be warm.  ***It is very important NOT to do this treatment in a person with impaired sensation or circulation in the feet, such as a diabetic.***   Here is a fun instructional video made by an NCNM student.

Once it has been found that there is no rupture of the eardrum, in a person without tympanostomy tubes, it is also possible and helpful to use ear oil drops.  There are many herbal formulations – one of the most common is garlic and mullein in olive oil.  You can find this oil at the health foods store, or make it yourself (ahead of time).  Warm the oil to body temperature before applying 2-3 drops in the painful ear.  You can put a cotton ball in afterward to help keep the oil in, if needed.  The warm oil is soothing and the garlic helps fight the infection.

I often get asked about ear candling for ear infections.  I do not recommend ear candling, as I find no evidence that it is helpful or even does what it’s intended to do.  There is also a risk of burns from the hot wax, as well as getting wax into the ear canal.  As you’ve already read, there are many simple, effective ways to treat ear infections.  Why use an ineffective, possibly harmful, and costly therapy instead?

The best way to treat an ear infection, of course, is to prevent it altogether.  Prevention includes maintaining a strong immune system, drinking plenty of water, and eliminating reactive foods.  Prolonged exclusive breastfeeding is also protective against ear infections in children.  Your naturopathic doctor is well-equipped to give you support with all of these.

One last note, there are other times to seek out medical help (not an exhaustive list):

  • Any fever in a baby under 4 months.
  • A fever higher than 104°F, especially if the cause is unknown.
  • Redness is not confined to the ear, but extends behind the ear.
  • There is swelling behind the ear.
  • An infant or child is listless, unresponsive, dehydrated, or your instinct tells you something is not right.
  • Home remedies have not helped.

I wish you a happy, healthy fall and winter, but if you or someone you love does get sick, now you have a home toolkit for feeling better faster.

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Kids’ Wellness Weekend


As a parent, you may wonder if there is any difference between a naturopathic doctor’s visit and a  conventional one.  You may be curious about how a naturopathic doctor is trained.  (Find out here.)  You may already be considering naturopathic care for your family, but were waiting for the "right" time.  Whatever your situation, now you have the chance to give it a try!

This holiday season, I’ve decided to spend a day giving back to my community.  I’m offering a low-risk opportunity to experience the real difference between naturopathic care and conventional care. 

It is true that a naturopathic doctor’s visit costs more than your typical insurance copay to see a conventional doctor – on the surface.  When you include the potential long-term expenses, however – additional doctor’s visits, medications, surgeries, and a reduced quality of life – a holistic and preventative approach to health begins to make real financial sense.  There is no better time to start this than at the beginning – in childhood.

For one day only, December 12, 2009, I am providing well-child visits for $30 (a $100 value for new patients).  Each 45-minute visit will include a physical exam, a developmental assessment, and information about nutrition and natural therapies for children.  (Read more about naturopathic well-child visits on my website.)

There are only five openings available, so make sure you don’t miss out!  Call (970) 232-8447 today to schedule your child’s appointment.  Experience the natural, compassionate, whole-child care that is naturopathic medicine.

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Baby Steps


Making changes can be overwhelming.  I know this from personal experience, and I talk with patients about it all the time, because so much of getting healthy is about changing habits.

In my own life, I find myself looking at my ultimate goal and thinking that it’s all too much and I don’t even know where to start.  Take cleaning the house, for example.  I really don’t like housework, so it’s a struggle to stay on top of two busy adults and three even busier kids.  I can clean a room and it will be like the aftermath of a tornado within half an hour.  Every few weeks, my husband and I spend a weekend in a cleaning frenzy, trying to get things in some semblance of order.

Patients often tell me how overwhelmed they feel too.  As they learn about one healthy change, and then another, the information starts to snowball.  At first they may be simply trying to eat real food, and then they learn about hidden ingredients, and that leads them to organic food, which then encourages them to learn more about harmful chemicals like bisphenol-A (BPA) and mercury contaminating food.  It can be enough to make a person go hide under the bed!

So what’s the trick to getting where you want to go?

I think there are four big steps: 

  1. Decide you want to change.  It won’t work if you’re doing it for someone else.
  2. Start small.  Baby steps work because they are easier than giant ones. 
  3. Focus on the change for one month.  It takes time for your mind and body to ingrain new information.  
  4. Give yourself a break!  We don’t always get things right the first time. 

So here’s how I’m trying to put it into action at home.  I decided that we really do need help managing the housework.  I’m ready for change!  I found a great site, FlyLady.net, that has an excellent "Beginner BabySteps" program and I started today with shining my kitchen sink.  (I didn’t use bleach, by the way.  The baking soda worked just fine.)  I will try to implement each of the changes for a month, and take a new step each day.  And I’ll try to relax when I forget one day or am too tired, and will jump back in the next day.

When you’re ready, you can make a small change too.  And know I’m working on it right alongside you.  :)

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