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Case Study: Empowered Approach to Fatigue

English

 

 

One of the key tenants of naturopathic medicine is education. In fact, one of the guiding principles of Naturopathic Medicine is Doctor as Teacher1. This principle highlights the empowering nature of naturopathic medicine. A naturopathic doctor simply provides the tools, education, and resources for each patient to work on their own healing. This is one of my favourite aspects of naturopathic medicine. It is so rewarding to witness patients take their health into their own hands when given the support and resources they need to help them on their journey. The following case report demonstrates how naturopathic medicine supports healing.

Meet Annie

probioticsWhen I first met 26-year-old Annie, she was exhausted. She told me how she had been vomiting every morning for the last 3 months, had no energy regardless of how much sleep she had, was frustrated, physically and emotionally drained, and felt like she was out of options. Annie had been working at a long-term care home as a recreation therapist and with the COVID-19 pandemic, staffing shortages, and feeling very overworked, she had decided it was time for a career change. She was just starting a new job where she could work from home. As we continued chatting, I learned that Annie had played competitive sports as a teenager, had been seeing a chiropractor since the age of 15 for various aches and pains and had a fairly stressful time in university. She told me about her frequent colds, flus, and infections especially in the fall and winter. She even told me about the year in university where she had strep throat 8 times throughout the year. She told me about her frequent headaches and migraines and how debilitating they were. She also told me about how debilitating her menstrual periods were and that she was regularly taking a combination oral contraceptive pill. She was concerned about having so many chronic issues at such a young age and her main goals were to improve energy, address her chronic headaches and migraines, and find ways to disconnect from work.

Assessment and First Steps

probioticsAnnie and I started slow. We started with getting a baseline of where things were at. From a traditional Chinese medicine perspective, it was clear that she was experiencing signs of spleen qi deficiency, likely due to her high levels of stress. I explained to her the importance of healthy digestion in obtaining optimal nutrition from her diet and how sub-optimal nutrition might affect energy levels as well as her immune system2We decided to start with a week-long diet diary. Annie was already taking vitamin D since she knew it was important to be taking in the winter. I advised her to continue, especially during the winter months and explained its importance in preventing a vitamin D deficiency, particularly with spending more time indoors and less time outdoors exposed to the sun.

First Follow-up

After 2 weeks, I had a virtual follow-up appointment with Annie. After our last visit she had gotten a cold. Her energy was lower than 2 weeks ago and I could hear her cough that seemed to come from her chest throughout our visit. She had gone for a chest x-ray at the recommendation of her family doctor and reported that her left lung was collapsed and she was now taking an inhaler that her family doctor had prescribed. She was also taking iron as prescribed by her family doctor for her iron-deficient anemia. This time, we decided to make some significant changes together. We talked about the connection between digestion and immune health and talked about some high-nutrient soups she could have while she was sick. We talked about eating warm, cooked foods, warming teas and spices, and we talked about avoiding cold raw foods, excess sugar, and dairy.

Two weeks later

At our virtual follow-up two weeks later, Annie was doing much better. Her cold had cleared and her energy had improved significantly. She had eliminated dairy from her diet and had been drinking water instead of pops and juices. She stated that the timing worked out well since she was observing Lent (a Catholic tradition of fasting). She was still noticing some nausea but she noticed it happen whenever she faced emotional upset. She also mentioned that she had stopped taking her oral contraceptive pill at the recommendation of her family doctor because her chronic migraines and long-term use of the pill put her at higher risk for a blood clot or stroke3. We talked about some strategies to help cope with stress and emotional upset and Annie came up with the idea to re-incorporate outdoor yoga into her daily routine. We decided the removal of dairy and replacing sugary drinks with warm lemon water were working well and to continue with those. We also continued with daily vitamin D supplementation. After going over her bloodwork together, we also added vitamin B12 and zinc. We talked about some alternative methods of contraception and she started a log of her menstrual cycle while researching her contraception options in preparation for her visit with a gynecologist.

Two-month follow-up

probioticsAt our two-month follow-up Annie was excited to tell me how much her energy had improved. She appeared brighter and more energetic over our virtual appointment. She reported having more energy throughout the day and being able to stay awake until 10pm, which was two hours later than what she was able to do before. Her headaches had become very infrequent and she had not had a vomiting episode since before our last visit. She had started incorporating stretch breaks and outside breaks into her daily routine. She had also become more aware of taking on the emotional concerns of those around her and started recognizing that those were not her concerns to take on. She also started doing word searches as a break, which she really enjoyed. We celebrated Annie’s success together and discussed the importance of continuing her new habits that she was finding so beneficial. We also talked about incorporating more cooked greens to help support liver and hormonal health as well as continuing with warm lemon water in the morning.

Three-month follow-up

At our three-month follow up, Annie reported her headaches returning after an emotional month of experiencing the loss of both her grandmother and aunt. Despite the challenges of the month, Annie was still doing quite well. She still reported her energy being much better than when we had started and was excited to continue with the changes she had made over the last 3 months.

probioticsSix-month follow-up

Annie and I continued meeting monthly and six months after our first appointment, she was doing quite well. She was still happy with her energy levels throughout the day and reported friends and family noticing how great she looked. She was still not eating dairy as she reported feeling better without it and was getting quite creative with her meals and snacks. She was excited to report how supportive her family was of her lifestyle changes and was now interested in shifting her focus to menstrual health. Since stopping her oral contraceptive pill approximately 6 months ago she had become more aware of her menstrual cycle and had even started tracking her basal body temperature to help her better understand her cycle and plan around it. We agreed to continue meeting monthly as Annie saw great benefit in the monthly health check-ins and discussed shifting our focus back to immune health in the coming months to prepare for the fall season.

One-year later

Over our year working together, Annie has made some significant changes to her diet and lifestyle and we have both had the pleasure of witnessing the drastic improvements that can come from these changes. The Annie that I met one year ago was exhausted, nauseous, and feeling defeated. Today Annie has lots of energy to get her through her days. She has become familiar with how different foods impact her body and how to eat in a way that helps her feel well. She has learned to set boundaries so that she is able to be present for herself and those around her. She has created a work environment that helps her be most productive without overexerting herself. She is more connected with her body, has learned strategies, and accumulated resources on keeping herself feeling her best. She has also learned where to turn and how to ask for help when she has questions, concerns, or things become overwhelming.

Where to next?

It has been an honour to be a part of Annie’s journey and watch her health improve as she diligently made changes with the new information she learned. Annie now has a whole new perspective on health and is always looking to improve her health and address any health challenges that come up along the way. I am looking forward to seeing where her health journey takes her next.