Steroids, Allergies and Bipolar Disorder: Q&A with Portland Nurse Practitioner Julie Foster

Julie Foster-Pohala Clinic
Julie Foster Nurse Practitioner in Portland, Oregon

Bipolar disorder author Julie A. Fast has been a client of mine for over 10 years.   We often discuss over the counter and prescribed medications that can cause mood swings for people with bipolar disorder. She’s currently writing an article on the topic and asked me to describe my process of prescribing steroids if a person has bipolar disorder or depression and what I use instead of a steroid when helping a client who has bipolar disorder or depression manage allergies or asthma.

Julie A Fast:  Julie, When you have a client with bipolar who has severe allergies, how do you talk with them about the effects of steroids on bipolar disorder if they have an allergy doctor who wants to prescribe prednisone? What is the plan if the person can’t take steroids, but they have terrible allergies?  Steroids are known to affect the mood. For many people with mood disorders, they can cause mania and depression. 

Julie Foster: In general I do everything I can to avoid steroids in the general population whether it be for allergies or other needs. However with my Bipolar patients,  I am extra cautious. Unless I have exhausted all other options and the person is finding no relief either completely miserable or their breathing is comprised I do not prescribe.

Allergies are on the rise as we are exposed to more environmental debris and toxins and the effects of modernism on our immune systems.  Here are my suggestions for clients who want to manage allergies without the use of steroidal drugs.

  1. Look at the diet. Many allergies come from the foods we eat.  Eating a healthy diet can be hard for people with mood disorders as food is often used for comfort, but small changes can make a difference. Look for what is called a clean diet, one free of preservatives, hormones and GMO food.  When possible, limit refined sugars (look at the label and if it says high fructose corn syrup- choose something else) and white carbohydrates and go for natural fruits and vegetables. This is never easy when you are not feeling well, but over time you will feel better and will hopefully have less allergies- which was the original goal!
  2. Think about your life rhythm.  This includes the circadian rhythm of sleep and the rhythm to your work and relationships. How is the stress in you life? Our bodies are connected to our minds. A high stress level can affect the immune system that then affects our ability to handle allergens.
  3. Try healthy remedies. Homeopathic remedies including Sabadila, Euphrasia comp and Allergist.  Use Vitamin C up to your bowel tolerance (if the tummy has trouble, lower the dose) and add steaming and sweating to your daily regime.  Use an air purifier at home and try a honey remedy (Julie, explain this one- what do you do with the 1 tsp of honey?)

Julie A. Fast:   Julie, when you have bipolar disorder, it’s essential you check everything you put in your body to make sure it doesn’t lead to mood swings. How do you help clients figure out this maze of treatments and medications when they are having trouble  breathing as well as having mood swings?

Julie Foster:  Some of the herbal and supplement options for allergies can affect the mood of a person with bipolar which is why I go with the above plan first.  Congestion from allergies comes up when the body cannot eliminate properly. Another natural option for managing allergies is proper digestion.    Acupuncture is a good option as well as massage and maintenance through osteopathic or chiropractic adjustments. People with bipolar disorder and depression can find steroid free ways to manage allergies and asthma.

Please call to make an appointment with Julie Foster or another member of the Pohala Clinic professionals.

Eating Disorder Help in Portland, Oregon with Nurse Practitioner Julie Foster of Pohala Clinic

Many of you know how my daughter was over-trained as an gymnast and ended up grossly underweight (BMI 14.5). Within a few months already thin she grew 3′ and did not gain weight. This is called the Female Athlete Triad:

  1. No Menses
  2. Tiredness
  3. Less intake than expended

Over the years I have educated myself, treated and coordinated care as a primary care physician with local eating disordered clinics, nutritionists, mental health providers. How humbling that I would have it happen to me even as a thoughtful vigilant medical provider.

My daughter’s experience brought a very personal eating disorder awareness to my practice I would not have had otherwise. I would like to share my journey with you to let you know that I am here to help all members of the family who want to find balance around food and a healthy body.

Eating Disorder Behavior in My Family

I realized that disordered eating and thinking is not as overt as what I had thought in the past.  As a result, I painstakingly reviewed my relationship and family history with food throughout my life. I realized that both my mother and father had eating disorders as well as other members in my family.  In order to be present to the needs of my daughter, I also had to look at my own relationship with food. 

I was naturally skinny most of my life, often accused of being anorexic when I was a competitive runner. I became a nurse, health conscious, and have bordered on orthorexia (an obsession with healthy eating) with good intentions. I personally was frightened to have gained 80# with my 1st pregnancy and wondered if I would ever lose it. Four years ago as I grieved my grandfather’s death, I found myself severely iron deficient with heavy menses. I was so fatigued, I stopped running.

Simultaneously we worked to re-feed my daughter. Her stomach had shrunk so much it could take over an hour to finish a meal. I sat with her and ate more as I worried about her eating.  It was then that I realized I binge eat myself and had been covering it up with my running. I live with social or personal anxiety and without the running to deal with this as well, I turned to food and gained 15 pounds.

 I felt my thinking pulled on a track of craving food. There is a positive outcome here. With the help of my counselor, naturopath, mindfulness, & self kindness…. balance returned. Compassion for myself and our society for what we face in our times has helped me find compassion around my own eating. 

What I Have Learned

1. It is not simply the parents fault (old theories blamed the mother) when a child has an eating disorder. Epigenetics play a role, like a flipping of switch. 
2. Be suspicious of weight loss in any child. 
3. What we say to children about food and bodies can trigger an Eating Disorder such as binge eating disorder. Teachers should never make a chart of students weight and BMI for others to see. 
4. Once an Eating Disorder such as anorexia is in place it creates a state of mind that cannot change unless the person is re-fed with real food, correction of brain chemistry.
5. Striving to be healthy can lead to an extreme, as an illness.  This is called orthorexia and is often referred to as an obsession with clean eating. 
6. With the right help Eating Disorders can be HEALED.

Vera Vos family nurse practitioner and myself excel in recognizing and supporting patients with Eating Disorders, present and past. If you want a provider who is conscious with their approach in words and deeds,  we are here.

Visit our Pohala Clinic contact page to make an appointment.

Julie Foster

Family Nurse Practitioner Vera Vos in Portland, Oregon Shares her Journey

Vera Voss

We love the diversity of our practitioners at Pohala Clinic.  The goal is to provide a variety of integrative and functional medicine practitioners who offer specific talents in order to fit individual client needs.

In this post,  Vera Vos talks about her path to becoming a family nurse practitioner in Portland, Oregon, her medical philosophy and how she approaches her work with new clients.  The compassion and enthusiasm Vera shows with all of her clients shines through when she talks bout her practice.

A Journey from Research Biologist to Family Nurse Practitioner

Before becoming a nurse practitioner, I was a research biologist doing field biology to determine health of animal populations. I found that disease and decreasing populations of animal species was always related to the health of their environment. After becoming a mother and experiencing first hand how human infants are so much like any other infant in the wild, I had an epiphany. We are like all other animals in that our health is also very much related to our environment. At that point diabetes and heart disease were on the rise as well as mental health problems.

I was passionate about helping people understand how our human culture and environment in many ways sabotages health (bad food, lack of movement, distractions, etc) and how to change personal habits to overcome those obstacles.

How Dr. Vos Works with New Clients at Pohala Clinic 

The first time I see someone, I like to listen to what they have to tell me. Of course I ask about past medical history, medications, etc, but mostly I ask them what they value about their own health and what they would like to change. Beyond physical health we talk about challenges and rewards in their personal lives related to family, social group and work as well as what brings them pleasure and what is difficult. I really get to know clients that way and this helps me see the bigger picture besides just their pathophysiology.

Views on Western and Easter Medicine

I don’t think of it as one vs the other. There are things to be learned and appreciated in both. I think the problems in western medicine stem from the stranglehold of financial stakeholders, not from the science itself. It’s the stakeholders that have preempted everything except pharmaceuticals and surgery to solve dis-ease. Unfortunately, this bias has resulted in managing disease instead of targeting and eliminating causes. Eastern medicine offers more options, but the emphasis is still on medicinals, usually plant based.

I have learned that most of what ails us comes from the outside. There is nothing wrong with us as human organisms. In fact, the more I learn about human biology and physiology (and we are not even close to knowing everything) the more amazed I am at the perfection of us. My goal is to use the best that I know of both western and eastern medicine coupled with mindfulness to quiet the “monkey” mind to help clients structure their lives to promote health and happiness.

When it comes to patients, I like all kinds of people of all ages. That’s why I’m a Family Nurse Practitioner. I love seeing kids because there is so much potential there to support healthy growth. But I also really like adults, both men and women as we work through issues together over time.

Vera Vos Hours at Pohala Clinic 

Monday and Tuesday all day and specific Friday mornings by appointment.

Please visit our Pohala Clinic Contact page to book an apportionment with Dr. Vera Vos.

 

 

 

Naturopath and Acupuncturist Paresh Shelat in Portland, Oregon

Paresh H. Shelat, ND, L.Ac

We welcome practitioner Paresh Shelat to the Pohala Clinic team. Dr. Shelat works as a naturopath and acupuncturist with a focus on whole body health.  We asked him to tell us more about his medicine philosophy, his education and his treatment and management goals as a health care professional.

“Your Body, Your Choice”

When I first meet a person, I want to understanding the stories and experiences that have led them to where they are today.  Creating a rapport that allows the person to feel comfortable in my office leads to change and optimal health in my opinion. It’s about the relationship I have with the people who have come to me for help. I truly believe in the idea of your body, your choice. I help people see their available options and we work together to make a choice that creates health and well being.

A Western and Eastern Approach

I believe it is essential to have an understanding of both paradigms, sometimes the terms naturopath and allopath (a western approach to medicine)  are used to describe the differences.  I work with patients to make informed decisions about how they want to dictate the outcomes of their health- this often involves both eastern and western practices.  There are times where the western standard of care is necessary and when the deviation from the standard of care can be safely completed under proper supervision.

Naturopath and Acupuncture Education 

I started off working in massage therapy. This opened up the path of discovery to the intricate world of medicine (both allopathic and naturopathy).   Graduating with a certificate in massage therapy led me to Johnson State College where I earned my B.Sc degree in Wellness & Alternative Medicine.  From here, I was able to attend the National University of Natural Medicine where I completed a dual degree program in both Naturopathy and Chinese Medicine. (Doctor of Naturopathy, Masters of Acupuncture). Upon completion graduation from NUNM, I finished a three-year residency in 2017.

I enjoy working with patients who are motivated and open to the possibility of achieving optimal health.  Unfortunately, there is no magical protocol or technique that will work for everyone.  With that said, the patients’ ability to have patience and an understanding that finding the root cause may take time is crucial. This leads to a collaboration that creates health and well being.

Please call Pohala Clinic to book an appointment with Dr. Shelat.

Getting to Know Lisa Del Alba, a Naturpath Doctor in Portland, Oregon

Lisa Del Alba

Our Pohala Clinic practitioners represent a wide variety of experiences and approaches to medicine.   Choosing a naturopath is an important decision. We believe that knowing how a person thinks about health makes a difference in the naturopath and client relationship. We hope you enjoy these thoughts on life and medicine from  Lisa Del Alba:

How do you approach a new client? 

When I see a client for the first time, my hope is, more or less, to get to know them as an individual. Rudolf Steiner once commented that there is as much difference from one human individual to the next as there is among different species of animals! My favorite part of my job is sitting face-to-face with my clients and hearing about their unique lives, and feeling amazement about how incredible it is that there can be so many different ways to live a human life. How do we all do it?  My ideal patient is someone who is interested in learning about their health, and co-working with me towards better health.

 

What led you to a career as a naturopath? 

Starting out my higher education with a combination-type of degree in physics, electrical engineering, and mathematics left me with a propensity to want to think things through. I heard lectures from physicists and mathematicians that left me with a sense of awe and wonder at the workings of the world and the universe. As a young mother, I remember worrying about my children when something unfamiliar would come up health-wise. For example, at one point, one child had persistent diarrhea, and another was chronically constipated. Like a ‘good mom’, I carted them in to see a local pediatrician. His brief explanations and suggestions were unsatisfying and didn’t seem to help anything. So, I started researching on my own.

After months of experiences, wondering, and researching, the questions only led to more questions. The whole process led to a sense of wonder and reverence for how the human being lives in their body, and how we all live in connection with the broader world. The human being was every bit as complex, fascinating and wonderful as I had felt the entire world and universe to be during my university studies! I remember thinking to myself; ‘Wow, this could be a full-time job’. A career change was in the making.

Tell us about your early life: 

I grew up in a household that, in some ways, held fairly conventional beliefs. I am fortunate to have had a supportive and fruitful upbringing with parents who were interested in life and taught and shared their interests. My dad grew up as a cowboy on a Colorado ranch, and was a practicing psychologist who also taught at a local college. My mom founded and directed a pre-school while being a full-time mom who cooked, sewed, knitted, etc. She eventually went back to school, received her doctorate, and worked for the University of Maryland. Both parents loved art, adventure, travel, the outdoors, and human diversity. They eventually went their separate ways, and I became a teenager.

With such a wonderful preparation by my life circumstances and my parents, I then proceeded to make many mistakes! I learned to work my way out of and through many and varied errors along my life path. These life experiences, among others, have deepened my ability to feel understanding for where a client finds themselves in their life situation.

What is your medical philosophy regarding natural medicine and the concept of Eastern and Western medicine? 

My scientific education has trained my thinking capacities, and my interest in the world keeps me learning and open to new possibilities. Anthroposophical spiritual science has provided an indispensable lens for a feeling and understanding which helps towards putting all of these various pieces together

When asked what my views are on ‘eastern’ and ‘western’ medicine, some people are surprised by my answer. In popular culture, many people think of allopathic (conventional or institutionalized) medicine as western, and almost anything else such as ‘alternative’ or naturopathic medicine as ‘eastern’. Actually, this is not a completely accurate picture. I think of ‘eastern’ medicine as medical systems arising out of ancient Eastern cultures – a few examples being Chinese and Ayurvedic medicine. The Western world also has its older medical traditions. Naturopathy has its roots in nature-cure practices in old-Europe and the Americas. Anthroposophical medicine has its origins in Central Europe and included an effort to bring ancient Eastern wisdom into the Western culture in a form that could be more understandable for Western constitutions and modes of understanding.

What are your office hours at Pohala? 

I work regularly in Portland at Pohala on Wednesdays from 9-5, and Thursdays from 9-1. (In Eugene, I work 9-5:30 Mondays, Tuesdays, and Fridays, and 2-5:30 on Thursdays.) Occasionally there are temporary changes in my schedule as needs arise.  I am the school doctor at the Eugene Waldorf School, and teach seminars to prospective Waldorf School teachers in the WTEE teacher training program. I find great value in working in a collegial way with teachers and other health care providers.

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Thank you to Lisa Del Alba for her thoughtful answers.  To make an appointment with Dr. Del Alba, please call the Pohala Clinic. 

Help from Acupuncture in Portland, Oregon with Malia Susee

 

Pohala Clinic focuses on the whole body experience for every client.  Whether you visit a practitioner for a specific illness, a check up or for chronic pain, our providers specialize in treating the body, mind and the spirit. Acupuncturist Malia Susee embodies this philosophy.

If this is your first time with an acupuncturist, Malia explains the philosophy behind her work and how she came to practice the ancient healing and chi balancing technique.

I have always had a love of language, learning, and travel. Along with this, I harbor a fascination with the human body’s anatomy, physiology, and energetic potential. I was a student of martial arts and yoga when my yoga teacher invited me to become her apprentice. She suggested I take a course in Anatomy and Physiology first– and when I did, “my hair caught fire,” (not really, but I became utterly engrossed!). I had received acupuncture on many occasions and found it helpful and curative. I realized that I could make this my life’s work. Once I looked into the education and practice of Oriental Medicine, I never looked back!

Visiting Malia is a relaxing and expanding experience. For those used to acupuncture, taking the pulse, looking at the tongue and asking questions about behaviors of the body will be natural. But when it’s your first time, it can feel like a new world. One filled with possibilities and healing.  Seeking the natural approach to a healthy mind and body is one process Malia loves sharing with her clients. Her goal as a health care professional is to actively listen and work with a person to find out a plan that helps the body find balance, healthy internal function and freedom from pain. She continues, “I want to understand what my patient is experiencing and wants to achieve, health-wise, and to use Traditional Chinese Medicine to not only develop a treatment plan, but to start treatment, on the table, at that visit.”

Malia treats many people who have chronic pain along with joint and muscle dysfunction, but she also has deep clinical experience addressing a patient’s hormonal and emotional imbalances, addictions, respiratory illnesses, strokes, concussions and traumatic injuries.

Malia is available for appointments at Pohala clinic on Monday through Thursday. Please call the Pohala Clinic office for her schedule.

Malia loves the challenge of helping people reach their health goals through balancing the energy of the body and the mind.  Acupuncture provides relief for menopause hot flashes, anxiety, insomnia, addiction, colds, stroke, concussions, traumatic injuries, migraines, cramps and more.

Visit Malia and learn about acupuncture and how it can help you find relief and the health needed to live a stable and happy life.

Healthy Snacks for a Natural and Nutritious Diet

Changing how we snack doesn’t have to mean deprivation. Innovations in snacks, oils, desserts, and more lets us have fun with food while staying healthy.  Whether you want chocolate that helps with weight loss or chips that heal your gut, this list has you covered.

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Eating Evolved / mbg Creative

Whether you’re dabbling with a keto diet or you just want to embrace healthier dessert options, these cups are a deceptively healthy delight. Eating Evolved is committed to embracing the motto “Chocolate: It’s Food, Not Candy,” and these cups do just that, with only four simple ingredients (organic cacao, organic coconut butter, MCT oil, and vanilla extract). Keep a stash in your freezer for whenever a chocolate craving strikes, and you’ll get the pleasure of something sweet while staying healthy.

The Best Healthy Snacks Of 2017 (So Far) Hero Image
The Coconut Cult / mbg Creative

The yogurt that’s taken Instagram by storm. Each of these dairy-free quarts contains over 800 billion human-strain probiotics. Meant to be consumed more as a supplement than as straight yogurt, it’s delightfully tangy (almost effervescently so) and pretty damn addictive. It can completely change our digestion (read more about that here).

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Bonafide Provisions / mbg Creative

These bone-broth-spiked beverages provide the perfect antidotes to the sometimes cloying sweetness of many bottled juice products by embracing the savory side of ingredients including spring peas, butternut squash, beets, red pepper, and more. The collagen in the bone broth can help heal your gut lining, but possibly more more enticing is the help you will receive with midafternoon cravings by the amazing umami flavor. You can consume these drinkable vegas either hot or cold. Click here to read more about the philosophy behind the Bonifide company. 

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Farmhouse Culture / mbg Creative

The first ingredient in these chips is dried sauerkraut, which may sound strange but adds just the right amount of tang to each bite. Each gluten-free serving contains 1 billion CFUs of probiotics, and the flavors, which mimic the Farmhouse Culture sauerkraut types, are out of this world. Try the Dill Pickle or the Zesty Garden Veggie—you won’t be disappointed.

The Best Healthy Snacks Of 2017 (So Far) Hero Image
Simple Mills / mbg Creative

These ready-made chocolate chip cookies have one of the simplest, healthiest ingredient lists around, based around a probiotic-rich tigernut, coconut, and almond flour blend. There’s no refined sugar, no gluten, and no artificial flavor or preservatives (they use only a bit of rosemary extract to keep these cookies fresh). The flavor, though is pure delight.

The Best Healthy Snacks Of 2017 (So Far) Hero Image
Bare / mbg Creative

These chia and coconut crispy bites are the perfect yogurt or smoothie topper, although they’re also amazing to eat on their own when you want a crunchy snack. They’re sweet, salty, and crunchy, making them oh-so-satisfying for any craving. The chia adds extra fiber and good fat to the coconut’s already solid profile, while the flavors (including vanilla and pineapple) add additional interest.

The Best Healthy Snacks Of 2017 (So Far) Hero Image
Siete / mbg Creative

These chips are essentially the healthy Doritos of your dreams, with a satisfying crunch and a powdery, finger-coating cheesy flavor. They’re made from high-fiber, gluten-free cassava flour and cooked in high-heat-safe, anti-inflammatory avocado oil. What you may wonder creates the cheesy flavor? That’s from B-vitamin-rich, totally vegan nutritional yeast.

We support healthy eating at Pohala. All of our practitioners can work with you on creating a healthy diet that meets your needs.

To Your Health!  

Team Pohala