Trip to Nicaragua to work with Natural Doctors International

Hi Friends,

This spring break I’m heading to Nicaragua to work in a integrative natural medicine clinic! I’ll get an opportunity to learn/practice medical Spanish, put my new physical exam skills to good use, integrate my recent coursework in a clinical setting, study global health in a developing country, prep for my upcoming clinical entrance exams, and volunteer my time to an organization that is giving so much to the local community of Ometepe! So much to look forward to, and everyone I’ve talked to who has already been raves about the experience. Home stays, community health, and a new country to visit… I’m so excited!

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If you would like to help send me to Nicaragua, please click on the link below. Anything you can give will be greatly appreciated! Thank you for following my medical journey, and for your friendship and support. I’m looking forward to posting all about my trip when I return in April!

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Burnout

Courtesy of Dr. Marnie Loomis, at NCNM, I learned a lot about burnout today. And as suspected, I score very high on the I-have-it scale!

What are the stages of burnout, you might ask.

1) Emotional and/or physical exhaustion. This might characterized by fatigue and cognitive weariness.
2) Depersonalization (cynicism). Symptoms include lack of empathy, mocking others, and loss of altruistic feeling.
3) Low sense of personal accomplishment. This may include a sense that you can’t do anything right, and worthlessness.

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“But Ash, isn’t it a little early in your schooling to get burnout?” you might say. Yes, I think so. But the trouble is, I started this way.

Don’t get me wrong, I had an amazing summer! Whales and mountain goats and bears, oh my! But transitioning from farm life on an island where my favorite thing was watching lambs play, to a summer on a small boat with 10 new people per week that it was my job to entertain and serve all of my waking hours… well folks, that just aint easy. Naturopathically speaking, it would’ve behooved me to bring along some sort of adaptogen or other support product, as well as cultivate emotional and mental sanity in my minuscule time off. Hindsight, 20/20, and all that.

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Stress does more than cause tension. According to Dr. Loomis, you are literally more brittle under stress. This is because each day your body is replacing and rebuilding cells and tissues. Stress changes the chemistry of your body, and each day you rebuild in stress-conditions is another day of reduced flexibility and less-than-optimum building conditions. So while fight or flight is an appropriate response when a herd of wooly mammoths is stampeding through, it is less than idea in a long-term stress situation. Like medical school!

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So what can we do about this? Many things! Depending on how far down the 3-stage pathway we find ourselves, this might vary. For instance, I find myself between a 2 & 3, so my first step was to seek out available resources for assistance. On campus at NCNM these include the student association and student life departments, student counseling center, tutors, student mentors, faculty mentors, and a program called Careteam, where we can actually seek help for classmates we are concerned for as well. Amazing.

If you’re not so far down the continuum and/or are more of a help-yourself type, other suggestions include:
Personal quiet time
Exercise
Spend time with family/friends
Spend time in nature, or if you can’t, with plants!
(seriously. an office study showed people around plants were 30% happier)
Get more (better) sleep
Eat regular meals
Take breaks!
Start a mindfulness practice
And many more…

Things to avoid, that may contribute to burnout include:
Alcohol or drug use
Skipping meals
Wishful thinking
Financial stress
Housing stress
Multitasking
Poor health
Debt
Isolation
Etc.

In the 6 hours since this presentation I have done these things to help myself:
Went to yoga (love Friday night yoga!)
Planned 2 study sessions with classmates
Planned a night of dancing to move my body and relax my mind
Spent time talking to friends about topics other than school!

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I have a ways to go, friends, but I am paying attention to where I’m at and taking steps to improve. Other things I have in the works are: cooking at home, seeing a counselor, establishing care with a naturopath, taking adaptogen supplements (Gaba, Opolopanax, and kali-phos), and cultivating a mindfulness practice. I will report back on progress.

If you are feeling signs of burnout, I urge you to take steps to reduce/eliminate stress and cultivate a stable state. Find resources, talk to family and friends, and direct your energy to things that will support your sanity and your health! We don’t have to correct everything at once. Promise yourself you’ll try something new for a week, and at the end of that week check in and see how you feel. Was it beneficial? Do you feel any better? Do you want to continue or try something else? Listen to your body and trust your intuition.

I’m going through this now, and if you are too, feel free to comment, and we can share difficulties and successes. I’m so glad I went to that talk to, this week has been a huge shift into gears for my self-care! I hope you can help yourself too.

A Brief Update

Dear Friends,

I am touched by how many of you remembered me today and sent a word of support on my first day of medical school. It was a sweet day all around. We had a welcome from the NCNM community, complete with drums, clapping, and a show of many faces in our first lecture. I had more opportunities to connect with fellow students. I even got to have dinner with my little bro. There will be a lot of work to do, but I am confident that I’m in a supportive community, surrounded by resources, and with an auspicious bent.

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Where have I been since April? Primarily Southeast Alaska! Frederick Sound. Chatham Strait. Stephen’s Passage. Juneau. Sitka. Hoonah. Kake. Petersburg!

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What a summer it was too. Having been hired on a 67′ charter cruise, I flew up to spend some time with friends I love. After  a week of R&R, it was time to board the vessel and heave to. My summer was spent in a continuous cycle of 7 days out, 2 days in, viewing the wildlife, the scenery, eating fresh fish, and enjoying diverse company, followed by two days of recovery! And what wildlife, spectacular! Whales and mountain goats, seals and seal lions, otters, birds, and bears, oh my!

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I plan to write a more detailed account, but I wanted to thank you for visiting in my absence! Much more to come in the weeks ahead!

Breathing the Tuesday air

Stress, stress STRESS!

First practical exam in osteopathic evaluation coming up a week from today, with the second one in osteopathic tutorials a week on its heels. Today I sat in on the class I missed last week due to travels, and so glad I did. We learn new things all the time, with very little class time spent on review, and while that seems totally reasonable, practical skills can be much harder to pick up than memorization. Somehow, even after two years, I still have trouble counting spinal vertebrae and palpating transverse processes in the neck. Does it even make sense that I can feel nerve and artery tensions and not bones? Hmmm…. something more to learn there.

Trying to clean house, create some space for my roommate who arrives Thursday bright and early. Two more classes, two more nights sleeping, and then taking the train to London for another epic airport moment. It’s funny, no matter how many tear-jerking airport scenes you see in the movies, it’s no less real when you get there. Never knew I’d get to partake, but no complaints! In the meantime there’s laundry to put away, floors to clean, bathrooms to sanitize, groceries to shop for, and maybe some new decor as my horoscope suggests.

Wish me luck as I clean/organize/study/transition/cohabitate/try to maintain stability! :)

Fimbriae, oocytes, and follicular liquor

Second day of embryology today. Learning the female anatomy and reproductive system. We’re waiting until next year to go over the hormones, since that takes us into endocrinology, so today it was anatomical and physiological. Much different than the male counterpart, more steps, more name changes, more complexity. Thank goodness I’ve been through this before, or my mind would be boggled! Continue reading

Cardiac physiology

I wonder if physiology professors everywhere hack on about the same things: action potentials in muscle cells, both cardiac and skeletal, and the contents of the cell. So many things I’m more curious about, like the human genome and DNA, transcription, meiosis and mitosis, brain chemistry, kidney function, etc etc. But somehow it seems to me that the longest lessons always wind up being on action potentials, with their sodium and potassium channels, depolarization, and concentration and ion gradients. Maybe it’s just UofO and ESO. Maybe these are just the ones I understood the first time (thanks Grant and Greg!).

So let me explain it to you, to test my knowledge!

The heart has two types of muscle cells: autorhythmic and contractile. Autorhythmic cells control the electric signal that initiates the beat of your heart. Contractile cells cause the actual beat you feel, pumping blood through the body, and coordinate the timing. Both of these work in a never-ending cycle of depolarization and repolarization.

Hokay, so… in autorhythmic cells, like any cell, sodium is constantly being pumped out and potassium is constantly being pumped in by ion pumps that live in the membrane. They do this to Continue reading