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I am an ND, LAc!

This shows my ND license. You can check yourself by following the link!
Look, it’s me!

Hey look, it’s me!

It’s a culmination of a dream/goal/ I have had since I was 17 years old! And it allows me to serve you with more robust healthcare!

I still have my LAc as well. As a “dual degree” ND, LAc I am still focusing predominantly on East Asian medicine at my location at Bridge To Becoming.

You can check this one, too.
from the Oregon Medical Board’s Licensee Search

Basically, this means that in addition to the care I already provide with acupuncture, East Asian herbal medicine prescriptions, aromatherapy, Shiatsu and Sotai massage, I am able to prescribe some medications, prescribe a lot of Western Botanical Medicines, do physical exams and diagnose some conditions, and also provide some additional services.

In a few months, I will also be providing more robust Naturopathic and East Asian medical care at Amenda Clinic, but not yet.

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biomarkers-vs-outcomes rants

Bio-markers and Bio-plausible not bio-promoting

Sometimes when my patients and I discuss a treatment option, I might get a little rant going about how researchers and health professionals and also patients are confusing bio-markers with actual health outcomes. This is especially significant when trying to evaluate whether a treatment is (1) evidence-based medicine and (2) whether the evidence is actually useful evidence.

There is a long but very interesting article co-published by ProPublica and The Atlantic, which everyone interested in health should read:
When Evidence Says No, But Doctors Say Yes, by David Epstein, published 2/22/2017. This article is primarily about how bio-plausible (it just makes sense!) treatments keep getting recommended to patients despite in-depth quality evidence showing that they aren’t useful.

I am very interested in this in general, but considering my particular pet peeve of biomarkers being confused for outcomes, this paragraph stuck out:

In 1997, a Swedish hospital began a trial of more than 9,000 patients with high blood pressure who were randomly assigned to take either atenolol or a competitor drug that was designed to lower blood pressure for at least four years. The competitor-drug group had fewer deaths (204) than the atenolol group (234) and fewer strokes (232 compared with 309). But the study also found that both drugs lowered blood pressure by the exact same amount, so why wasn’t the vaunted atenolol saving more people? That odd result prompted a subsequent study, which compared atenolol with sugar pills. It found that atenolol didn’t prevent heart attacks or extend life at all; it just lowered blood pressure. A 2004 analysis of clinical trials — including eight randomized controlled trials comprising more than 24,000 patients — concluded that atenolol did not reduce heart attacks or deaths compared with using no treatment whatsoever; patients on atenolol just had better blood-pressure numbers when they died.

I’m diverging from the topic of the article to point this out, because it is very important when weighing your options.

A colleague asked the Facebook hivemind what questions she, as an accompanying advocate, should ask the physician/surgeon of a friend who had debilitating back pain about a proposed surgery. Many people chimed in that in addition to her already proposed “risks, alternatives, and physician experience” and etc., she should absolutely ask about the expected result of the surgery. This goes for medications and nutritional changes and physical therapies as well. What are you trying to achieve? What can you expect to achieve?

A lot of interventions (medications, nutritional changes, exercises and physical therapy… anything you change in order to make a difference) have been tested against whether they make a difference in bio-markers because it is too costly and risky to see if they make a difference in actually important things like quality of life, mobility and individual agency, and duration of life. They’ll therefore conflate a biomarker known to be involved in the outcome, such as LDL cholesterol or blood pressure, with the outcome of Not Dying Suddenly From A Heart Attack or Permanent Disability After A Stroke. Again, the reason is that it’s often too costly or too difficult/unethical to get permission to run a study long enough to find out; but that means that there’s lots and lots and lots of treatments out there that make your numbers look pretty without addressing the cause for those numbers to be “off.” They also confuse people as to whether the biomarker is the cause of an outcome, or just related to the outcome. Things like LDL cholesterol can be a predictor of cardiovascular disease but don’t necessarily cause CVD!

This doesn’t even get into the difficulty of studying one particular outcome, like cardiovascular disease or skin cancer, while ignoring all other outcomes, like autoimmune disease, diabetes, other types of cancers, infection, and all sorts of other things that can make life difficult or make life end. Or being so focused on reducing the biomarkers of one disease (blood pressure as an indicator of CVD) that you take risks with other diseases (blood pressure medications making diabetes mellitus type II more common) which can increase mortality or reduce quality of life.

It’s a very tricky balance. It’s not something that you can just figure out by finding the one right study.

That’s why it’s important to find clinicians who will work with you holistically –as a whole complex person– to figure out which risks are the real risks, which biomarkers are worth chasing down into pretty, non-threatening ranges, and which interventions are actually helpful versus which ones are just to cover everyone’s behind.

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social-justice Uncategorized

Social Determinants of Health

Need justice, have umbrella, willing to march!
Coming together to ensure mutual security and wellbeing, rain or shine!

The social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries.

As a part of my education in East Asian medicine and Naturopathic medicine, we looked at not only individual determinants of health (your behavior, your choices, your genes and your upbringing) but the social determinants of health (Are you persecuted by your government or by fellow citizens? Do you have freedom of movement, of the ability to better yourself, to accumulate wealth for security?)

This political climate calls upon us to clarify our values and to look at how our actions influence others, and our role in upholding, ignoring, or resisting our social norms and government codes.

To that effect, I want to share these documents about how we can make sure our Representatives in government truly represent our interests, and how to resist without undermining your cause.

Indivisible Guide: A PRACTICAL GUIDE FOR RESISTING THE TRUMP AGENDA, Former congressional staffers reveal best practices for making Congress listen.  This is both a guide translated into many languages and in both written and audio format, and a community for support.

198 Methods of Nonviolent Action: Practitioners of nonviolent struggle have an entire arsenal of “nonviolent weapons” at their disposal. Listed below are 198 of them, classified into three broad categories: nonviolent protest and persuasion, noncooperation (social, economic, and political), and nonviolent intervention.

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Big Medicine

Electra Allenton, ND, MSOM, LAcTwice recently, I’ve been given a gift of someone’s medicine.  It’s not what you’re probably thinking.  In today’s troubles with an opioid epidemic, with ADHD medication sharing or selling on school campuses, and things like that, being given medicine sounds very strange.  I’m not talking about pharmaceutical drugs, though.

I’m talking about plant-based medicine that heals as much through history and meaning as it does through phytochemicals.

I am talking about relationship and communication, fostered through our less intellectualized senses like smell and taste and touch, between humans and humans and between humans and our world.

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Those waters are still troubled, but we’re coasting along.

Electra Allenton, ND, MSOM, LAcDear ones, I’m ready to go!  How about you?

For anyone looking back…back…back through time at this blog post, I want to give you some context.  It is November of 2016.  Last week, Donald J. Trump became our president-elect.  There’s almost no one in the country who hasn’t had an emotional response, whether it’s elation at having the sense of being heard and seen, or fear at what drastic changes will come.  Everyone’s relative sense of safety has shifted for better or worse.  And, our country is remarkably polarized.

My clinic is in Portland, Oregon.  I’ve lived in Portland on and off since 2001, and I’ve lived in quite a few places in the United States and in the world.  I am a white, cis-female, neurotypical human being. But even though I am these things, I want to assure you –whoever is blessing me by reading my post here– that I am doing my best to seek training and experiences so that you are safe in my care.  You’ve maybe looked around my website to get a sense of who I am and what I offer to my patients.  I want to, straightaway, tell you my core values:

I value quality of life.

I value informed autonomy and agency – a.k.a. independence –
within an interdependent society.

I value a strong and resilient sense of self.

I believe these things are the root of healthy self-esteem, healthy relationships and the basis of a secure place in society.

I’m currently starting up my practice, but once it’s rolling smoothly I hope to donate some of my net income (after my professional bills are paid but before I get paid) to charities that will support vulnerable people in our country. There are so many to choose from that I haven’t decided yet, but I think the ACLU reflects my values pretty well.  They are also generous in lending lawyers to other organizations who defend the vulnerable among us.

I look forward to meeting you, and hope I can be a bridge to your becoming whole!