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BriefCase: Pancreatitis And Cholesterol Medication

A few weeks ago, a lovely patient of mine asked me if I could help her father who was dealing with acute pancreatitis. As soon as she said it, I winced because it is supposed to be exquisitely painful and internal organ pain is the kind of pain that is difficult to escape. There is no good way to find relief. Still, I told her to tell her father to come in and see what we could do for him.

When I first met him in my office, he was very weak and clearly in discomfort. Now, acute pancreatitis is not something that I come across much in practice. So, the only risk factor that immediately came to mind was heavy alcohol consumption. While he previously enjoyed the occasional drink, by the time I met him he had given up alcohol completely for several weeks. There were no other obvious risk factors from the remainder of our interview.

That is until I asked him about medications…

Turns out that this patient has a family history of high cholesterol (but incidentally no family history of cardiovascular disease – could it be that the two are not as closely linked as some may think?!!). He has been taking Fenofibrate to lower his cholesterol. When I asked how long he had been on the medication, his answer left me dumbfounded.

“Oh, a long time. Maybe twenty-five years or so?”

TWENTY-FIVE YEARS?!! Has your dose changed?

“Nope.”

Well, a quick Google search shows that there is an association between Fenofibrate (and other lipid-lowering medications) and pancreatitis. Luckily, the patient was scheduled to have a visit with his specialist and so I instructed him to talk to the specialist about a possible link between the medication and the pancreatitis.

Unfortunately, the specialist was not very helpful and was mostly concerned with imaging of the pancreas. When asked about whether the Fenofibrate should be discontinued, the specialist said “no” because if there was a causal link that symptoms would have occurred a lot sooner.

Now, no one can know with absolute certainty what caused the pancreatitis. However, all drugs have side-effects and the more drug in your system, the greater the risk of side-effects. In this case, there are no other obvious risk factors for pancreatitis so the Fenofibrate should be considered the most likely cause. In my opinion, it should at least be ruled out by reducing the dosage or changing the medication completely.

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New Year’s Detox – Better Late Than Never

It happens every year. December is a crazy busy time of year. There are lots of gatherings and parties. And LOTS of eating and drinking. Then you mix in some stress, a lot of unseasonably cold temperatures, and coughing and sneezing and your body has taken the proverbial “Season’s Beatings”.

The social aspect of food is one of the most challenging to overcome. Now, it’s January and all the celebration is finished. At least it is for me. And that is why it is a perfect time to give my body a tune-up – a detox to give the digestive system and other internal organs a well-deserved rest!

Some people talk about doing a detox or cleanse as a way to restore the liver back to optimal shape. After all, all those glasses of wine and spirits do place extra stress on the liver’s detoxification pathways. Because the liver is the major internal organ for detoxification, if it becomes overtaxed then it will have to pass of some of the overload to the other routes of elimination (also called emunctories). Organs such as the lungs and kidneys are less well-equipped to deal with such toxins but will pitch-in if called upon. I know that for me, the detox is necessary in order for me to decrease my pain and suffering from hayfever during the spring allergy season.

There are many ways to detox your system and the best one will differ for everyone. Personally, I’m planning to do this for 21 days. However, I would say that all detox protocols will involve some degree of dietary restriction and reduced demand on the digestive tract. The organs that typically get addressed are the liver, kidneys, and gut. And while such an approach will likely leave one feeling better than they did before, I think that a truly effective detox protocol needs to include some biotherapeutic drainage remedies. While most approaches are quite safe, the more aggressive the detox, the more important it is to ensure supervision by a medical professional.

On a cellular level, the goal is to ensure that the body is able to transport nutrients through the extracellular space to the cells. Similarly, the wastes produced by the cell must also be free to be excreted from the cells and out the body. Better absorption and better elimination makes for a more efficient and healthier body.

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What Is Naturopathic Medicine?

Coming up with a clear definition of what naturopathic medicine is has been more challenging than one might think. You see, the task of answering the question “What is naturopathic medicine?” has been an ongoing one for several decades. There are several reasons why it is hard to answer the question, but I think the biggest reason is that scope of what we do as naturopathic doctors is so wide and it differs greatly depending on what jurisdiction you are in (thankfully, British Columbia has the widest scope of practice in Canada). Perhaps this is why many naturopathic doctors and clinics explain what they do in the form of a menu of therapies offered. Unfortunately, for those who are not familiar with naturopathic medicine, how would they know what therapy they need?

For the past few years, I have been serving as co-president of the British Columbia Naturopathic Association (BCNA). This year, the BCNA partnered with the Canadian Association Of Naturopathic Doctors and other naturopathic associations across Canada to take a bold step forward to address this problem and figure out how to convey to the public what naturopathic medicine is and what naturopathic doctors do. However, before creating this message we had to do some market research first. We needed to ask people what they wanted to know in order for them to see a naturopathic doctor.

Needless to say, what they told us was enlightening!

When it came down to it, most people who had at least some idea of what naturopathic medicine was still felt they needed clarification about some of the most basic things about naturopathic practice. These included wanting to know that naturopathic medicine is a regulated health profession and that naturopathic doctors are medically trained. Most were surprised to know that naturopathic doctors are able to order blood tests and other lab testing as well as perform annual checkups. For a profession as old as naturopathic medicine is, it seems to still be one of healthcare’s best kept secrets.

Medically Trained, Naturally Focused

With this information now gathered, the Canadian Association Of Naturopathic Doctors (CAND) put together a public awareness campaign with the simple tagline: “Medically Trained, Naturally Focused“. Along with a series of short videos featuring licensed NDs that aired on national television, this phrase encompasses what we are in four short words. For all of the variation within our profession, all licensed NDs go through rigorous medical training and use treatments based on the fundamental principle that the body has a natural ability to heal itself.

Now that wasn’t so hard, was it?

 

 

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BriefCase: Plantar Wart Treated With Homeopathic Thuja

Plantar wart homeopathy thuja

BriefCase features short recaps of clinical cases that I have encountered.

It is always helpful for me to read about other people’s successful cases. You never know what you’ll comes across so I thought I’d share some of the ones that have crossed my path. 

For the first case, I thought I’d tell you about my daughter’s plantar wart. Ok, granted. At first glance you may not be that interested in hearing about a wart. However, for all of those who are parents, any time you can help bring your child out of a state distress you feel like a million bucks!

Patient: 5-year old female

Chief complaint: itching and irritated skin at site of wart on heel of foot

Diagnosis: plantar wart from HPV (probably contracted from swimming lessons or gymnastics class!!!)

Warts are challenging to treat. I tried a number of unsuccessful treatment approaches with my daughter’s plantar wart including:

  • 17% salicylic acid (like the Compound W my parents used on me back in the day)
  • Soaking the skin in warm water and filing it down with an Emery board
  • Topical essential oils

    All of the above had little to no effect. In fact, the salicylic acid dried out the skin surrounding the wart while the topical essential oils even made my daughter complain that the wart became “itchy” and started to “hurt”.The wart was more flat from filing it down, but the radius of the hardened skin around the wart was spreading.

    I did not try topical application of green banana peels or duct tape – couldn’t rationalize those approaches. I also did not want to try liquid nitrogen to freeze the wart. The reason for avoiding this is due to a very unfortunate case of another patient who had a plantar wart on the sole of her foot frozen by her doctor and it caused a debilitating complex regional pain syndrome (CRPS). Definitely not worth the risk!

    In the clinic, we have anti-viral IV oxidative therapy options like ozone, UVB, and hydrogen peroxide but there’s no way my daughter would go for any of those!

    In the end, I turned to homeopathy. My daughter is very compliant to the treatment (what kid doesn’t like taking medicine that tastes like candy?) and the discomfort from the wart was causing her increasing distress.

    I gave her Thuja 30C – 3 pellets daily. Within a few days, the center of the wart became very dark and surfaced like a scab. Within a couple more days, the surrounding skin was no longer red and hardened while the center of the wart fell out. Needless to say, I will be searching for the homeopathics first if it happens again.

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    Simple Science: The Extracellular Matrix

    From a physical perspective, our bodies are made up of organs, organs are made up of tissues, and tissues are made up of cells and the fluid-filled space that they swim around in. And for all of the very complex health problems that we see as naturopathic doctors, many of the cures to those problems start by working on that fluid-filled space – referred to in biology as the extracellular matrix.

    Dr. Chan is a South Surrey naturopathic doctor who uses biotherapeutic drainage remedies and IV nutrient therapy

    Nutrients flow through the extracellular matrix and are then absorbed by cells

    The extracellular matrix provides a “soup” of various proteins, sugars, and other components that give tissues their structure and elasticity. Of course, different tissues will have different “soup recipes” but the extracellular matrix provides a supportive environment for cells of that tissue to thrive within.

    Nutrients are obtained from food and then absorbed into the blood. The blood then transports those nutrients to various tissues throughout the body and then are floated through the extracellular matrix to the cells. The cells absorb the nutrients and excrete their waste products back into the extracellular matrix. The waste materials then flow into the the lymphatic system to be carried back out of the body.

    When everything is functioning in a healthy normal way, the extracellular matrix is fluid and allows for efficient exchange of nutrients and waste. This is the healthiest environment for cells to exist in. However, diets that are high in sugars and chemicals and deficient in water and minerals can gradually turn the extracellular matrix into a viscous sludge. Lack of physical exercise and a sedentary work environment results in reduced lymphatic movement and increased congestion in the extracellular matrix.

    Imagine how difficult it would be to float nutrients through a nasty, sticky, soupy mess like that. It would probably take a lot of extra effort and reduce your overall energy, right? To compensate, the body raises the blood pressure to push nutrient through the congested muck. However, if dietary and lifestyle changes are not undertaken then the body vicious cycle continues and you will need medication to suppress the increasing blood pressure to save your heart from the additional wear and tear (or to prevent a blood vessel in your brain from popping). The irony here is that the drugs and other toxins add to the pile of garbage that are congesting the extracellular matrix.

    Dr. Chan is a South Surrey naturopathic doctor who uses biotherapeutic drainage remedies and IV nutrient therapy

    Nutrient deficiencies result in an unhealthy tissue

    An unhealthy extracellular matrix in the body is a lot like unhealthy soil in a farmer’s fields – the crops you want will struggle and you’ll end up with a lot of unwanted weeds. Mineral-deficiency and toxic build-up of wastes creates a more acidic tissue environment. While your body’s cells have a difficult go of it, microbes can proliferate. They can even start to use the proteins and sugars in the extracellular matrix to shield themselves, forming a protective biofilm that houses chronic mixed infections (bacteria, viruses, yeast, fungi, etc.). As the pH drops more and the tissue inflammation grows, the conditions for cancer cells to flourish in are established.

    Dr. Chan uses biotherapeutic drainage remedies to restore the extracellular matrix

    You can restore your extracellular matrix back to health

    Naturopathic medicine incorporates many therapeutic approaches to reclaim the extracellular matrix. There is rich heritage of German biological medicine and biotherapeutic drainage that specifically addresses the body on this level. Also, our South Surrey clinic offers treatments such as ozone and IV nutrient therapy. Needless to say, however, it is all for naught unless you adopt simple but effective dietary and lifestyle measures. Drinking adequate amounts of water, eating nutrient-dense foods (such as mineral-rich veggies!), avoiding processed foods, minimizing use of prescription medications, and getting adequate physical exercise are all absolutely essential. Without fixing the extracellular matrix first, it’s hard to do anything else.

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    IVs After Weight Cuts Are Banned – Now You Know

    Dr. Victor Chan is a South Surrey sports medicine naturopathic doctor who offers IV nutrient therapy

    Severely dehydrated patients receive IV fluids

    se·vere·ly

    I never intended for it to happen, but a significant portion of my naturopathic medical practice deals with sports medicine and treatment of athletes. The people who come to see me for their aches and pains can range from my young student athletes with Osgood-Schlatter (for a while I was seeing waves of volleyball and basketball players with very sore knees!) to the weekend warriors who’ve tweaked a few things trying to re-live the glory of days gone by and up to the Olympians and professional athletes. The common ground that all athletes have is that they want to push their bodies to the absolute limit and they come to look for natural (and definitely non-surgical) was to improve.

    May fighters see naturopathic doctors to safely cut weight

    Fighters need to “make weight” before they are allowed to compete

    About eight years ago, an athlete came to my office explaining that he was a professional mixed-martial arts (MMA) fighter. Although he was dealing with numerous aches and pains, the main thing that he wanted help with was his weight cut. I knew immediately what he was talking about because years (and I mean MANY years) before that I had tried my hand at amateur wrestling, which is a sport notorious for the dangers of “cutting weight”. In a nutshell, MMA, wrestling, and other combat sports have athletes competing within a weight class. This makes sense from the perspective that it prevents having a larger opponent competing against a smaller opponent because, all other factors being equal, size is a significant advantage in combat sports. So, in order for a bout to take place, both fighters must weigh-in below a specified weight at a certain time (in MMA, this is typically the day before the match).

    As a consequence of this, fighters will attempt to lose significant weight in the days (and hours) just prior to the weigh-in. Obviously, the only weight that one can lose in such a short period of time is from loss of body water – in other words, they dehydrate their bodies. Often times, athletes will be so dehydrated that their muscles are cramping and they can barely walk. Imagine what is happening to your other tissues and organs when the body is in such a state. You don’t have to be a doctor to know that this is EXTREMELY unhealthy. If you showed up in such a condition at the emergency room, you would most definitely be given intravenous (IV) rehydration. No surprise, then, that as a naturopathic doctor I have often administered IVs to fighters after their weigh-ins.

    Only one problem – it’s against the rules.

    That’s right. In a discussion with BC Athletic Commissioner Wayne Willows, he was very clear that IV rehydration is absolutely not allowed for athletes competing in events in the Province of British Columbia. This ban is also upheld by the US Anti-Doping Agency (USADA) and in fact, this is the same policy that will be implemented in October 2015 by the largest MMA organization in the world, the Ultimate Fighting Championship (better know as the UFC). The hope is that banning the practice of IV rehydration after weigh-ins will discourage athletes from cutting extreme amounts of weight to compete in lower weight classes.

    Will it work? That is up for debate. On the one hand, people say that severe weight-cutting is dangerous and the practice needs to be discouraged. Others say that as long as a sport has weight classes, there will always be athletes trying to cut as much weight as possible and banning IV rehydration is going end up in athletes dying. The rules are the rules, though, and it is the athlete’s responsibility to abide by them and knowing the rules, I will absolutely inform the athlete that I will inform the fight promoter that my treatment will disqualify them from competition. As a naturopathic doctor, however, if you’re in a situation where your health is at risk because you’re dehydrated, I am going to recommend that you get an IV to rehydrate. There is no gray area there.

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    Yes, We Can Do That Test For you

    Dr. Chan is a naturopathic doctor in South Surrey offering lab testing

    Naturopathic doctors offer LOTS of different lab testing

    The other day, I was taken aback by a question from a new patient. She asked me, “Dr. Chan, are you able to order… lab tests?” The tone in her voice was almost as if she was taking a stab in the dark and expecting her query to go nowhere. In my mind, I was thinking, “Can I order lab tests? OF COURSE!!! Pick a test, any test!”

    Sometimes, as naturopathic doctors, we get caught up in our own little world and forget that the majority of people have little idea about what we can do or the kinds of conditions we can treat. As a naturopathic doctor practicing in the lower mainland, I can write a lab requisition and send my patient to any LifeLabs or BC Biomedical collection site to have testing done, just like a patient would if they were being sent by their family doctor. The big difference is that MSP covers the labs requested by the MD whereas the patient pays out-of-pocket for the tests that I request. The question is, then, why would anyone bother going to a naturopathic doctor for testing?

    There are several reasons for this. Besides the fact that many people choose to have a naturopathic doctor as their sole primary care provider (perhaps because they cannot find a family medical doctor who is able to take them on as a patient), naturopathic doctors are not as restricted in the types of tests that they are able to order. This is because when the patient pays out-of-pocket, they have the power to choose from the full array of testing available. On the other hand, when public funds are being used to cover the testing, the testing options are much more restricted.

    Take for example the patient who asked me about whether I was able to order lab testing in the first place. She said, “I want to get my thyroid checked.” After inquiring a bit more about her health history, she explained about her symptoms relating to fatigue, weight gain, and poor mood but every blood test that she had done showed that all her results were “normal”.  The problem here is that the typical screening blood test only includes thyroid stimulating hormone (TSH) and if the results show levels within the normal range then that is as far as the testing path will go. Yet, a full thyroid panel will also show levels of inactive and active thyroid hormones that can give more useful information to help understand what the dysfunction is.

    Furthermore, there is a plethora of advanced laboratory testing for things such as hormones, allergies, parasites, heavy metals, nutrient status, genetic defects, and more. Much of this testing is better able to identify DYSFUNCTION versus most standard lab testing which is geared towards identifying DISEASE. Functional testing allows us to provide treatments to help patients achieve optimal health rather than waiting until someone is sick before doing anything.

    Like anything, you can have too much of a good thing. Without a strategic approach to assessment and diagnosis, lab testing can get very expensive and it is my job as a naturopathic doctor to provide my opinion to patients about the kinds of tests that will provide the most useful information to help them get better faster. So, ultimately, it’s better to have too much choice than not enough.

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    Our Dream Clinic

    Dr. Victor Chan graduated from CCNM

    I spent a LOT of hours learning my craft at CCNM, located at the corner of Leslie and Sheppard in North York, ON.

    After graduating from naturopathic college in 2003, I left Toronto to return home to Edmonton [*insert joke here]. After exhausting my brain and burning out my adrenals from four years of intense study, I couldn’t wait to get out there and start putting my theoretical knowledge into practice. I felt like naturopathic medicine was one of the best kept secrets and that once I put the word out there, people would say, “Wow, that’s EXACTLY was I’ve been looking for. I was ready to take on the world!

    Well, things didn’t exactly start off the way I expected…

    Dr. Victor Chan first started practicing in Edmonton, Alberta

    In 2003, I started practicing in a clinic just across from West Edmonton Mall

    At the time, most people only knew to see the doctor if they were SICK or for their annual physical check-up. People weren’t connecting with the notion that a naturopathic doctor could help you increase your energy, get better sleep, soothe your gas and bloating, improve your mood, strengthen your immune system, lose weight, normalize your blood pressure and blood sugars, and on and on and on.

    Instead, the people who started coming through my door were the REALLY SICK people. These were patients who had seen their family doctor and the specialists. They’ve already sought out the second opinions. Probably spent a lot of money trying remedies and alternative practitioners. Now, they were showing up saying, “You’re pretty much my last hope.”

    [*insert panic here]

    Fast forward to April 2013 at the American Association Of Orthopaedic Medicine (AAOM) 30th annual conference in Phoenix, Arizona. As I’m registering for the start of the conference, I’m surprised to see so many familiar faces – naturopathic doctors! One of those faces just happened to belong to my old colleague, Dr. Adrian Yeong. Throughout the weekend, we learned about the latest advances in prolotherapy, platelet-rich plasma (PRP), and autologous stem cell treatments for joint pain and injury. The information was so MIND-BLOWING to us that the level of excitement reminded me of exactly how I felt when I first started practicing. Then, a bit of reality set in when we did the math about the costs of equipment, the logistics of setting up a clinic to accommodate these types of advanced therapies, and the time that it would take to get something like this going. That’s when I said to Adrian, “Too bad we couldn’t do something like this together…”

    The SCIMEDICA Health Group clinic is located within the Croydon Business Centre in South Surrey

    The SCIMEDICA Health Group clinic is located in the Croydon Business Centre in South Surrey

    Fast forward to September 8, 2014. After many months of planning, Drs. Kira Cai, Adrian Yeong, and myself saw our first patients at the SCIMEDICA Health Group clinic in South Surrey. It is a 2,500 square foot facility that we had built out to our specifications and can now offer the most comprehensive and advanced therapies to our patients. We have things the ability to treat patients with a wide variety of conditions and levels of health. It has taken a ton of hard work and just as much good fortune (thank goodness I crossed paths with Kira and Adrian!) to realize this dream and now I practice as a naturopathic doctor in South Surrey (as well as in Burnaby).  So now, when someone comes through our doors and says, “You’re pretty much my last hope,” I don’t panic anymore. I get excited – just like I did back when this whole journey began.

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    • Clinic Locations

      South Surrey
      SCIMEDICA Health Group
      #212 - 2630 Croydon Drive
      Surrey, BC V3Z 6T3
      Phone: (604) 541-8811
      Fax: (888) 852-1425

      Burnaby
      Perfomax Health Group
      6170 Kingsway
      Burnaby, BC V5J 1H5
      Phone: (604) 433-0100
      Fax: (604) 433-0011

      Email: info@drvictorchan.com

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