Monday, August 5, 2013

Harvesting Artist's Conk (Ganoderma)

Although I primarily use plant species in my practice, I also use several medicinal fungi. The first group of medicinal fungi that I started using about 15 years ago were several of the Ganoderma species. These are bracket fungi or conks that grow on wood. Of the various members of this genus, by far the most popular is lacquered polypore (G. lucidum), better known by its Japanese name reishi. This species grows on a number of different hardwood trees. Although it is circumboreal, growing throughout the temperate regions of the northern hemisphere, it is rare in the region where I live. As a result, I primarily use artist's conk (G. applanatum) and hemlock varnish shelf (G. tsugae), which are quite common in this area. All three species have similar properties.

I came across this lacquered polypore (Ganoderma lucidum) in mid June this year growing from the base of a
beech tree (Fagus grandifolia). It is one of the few times I have seen it growing in the region where I live.

I have used all three of these Ganoderma species. Lacquered polypore is not common where I live, however, one year I purchased a log that was inoculated with the spores of this species and grew it so that could make a tincture of the fresh fruiting body and compare the properties of all three species. Although it is not as well know as reishi, I actually have a slight preference for artist's conk. However, in my practice I usually use a 50/50 mixture of the tinctures of the fresh fruiting body of artist's conk and hemlock varnish shelf. I sometimes mix closely related species that have similar constituents and properties to increase the diversity of chemical constituents in the medicines that I use. I find that closely related species are often mutually synergistic and the properties of these combinations are sometimes more consistent and versatile than using the individual species.

Hemlock varnish shelf (Ganoderma tsugae) often looks very similar to lacquered polypore, but it grows almost
exclusively on hemlock (Tsuga spp.). The margin is whiter compared to the photo of
lacquered polypore (see above) because this one is still growing.

Artist's conk is one of the most adaptive fungi in terms of the variety of tree species that it can grow on. It primarily grows on hardwoods, but on rare occasions I have seen it growing on conifers as well. That being said, in the region where I live it most commonly grows on sugar maple (Acer saccharum) and American beech (Fagus grandifolia).

Unlike its relatives, the fruiting body of artist's conk is perennial. If the conditions are right it can grow for many years. It is brownish with a woody appearance on top, but the underside is white and somewhat rubbery. If we draw on the underside with some kind of stylus, it leaves distinctive lines that will be preserved if the fungus is dried. This is how it got its common name. I have seen some pretty amazing pictures that were drawn on artist's conk!

Artist's conk used to be one of the most common fungi in southern Ontario. However, in the last few years it has become less common. As a result, I have found it a little more difficult to find good harvestable specimens. I suspect it has something to do with the average age of the forests in our region. From 1980 to 2005 there were a lot of very old beech and maple trees that gradually died off. There aren't that many of the oldest ones left in a lot of the forests that I frequent. This is just my hypothesis. There are probably other reasons as well.

The fruiting body of artist's conk (Ganoderma applanatum) is perennial and can grow for many years.

I use a moderate amount of Ganoderma tincture in my practice. Typically about 4-6 litres per year. Since I mix artist's conk and hemlock varnish shelf, that means I need about 2-3 litres of each species per year. The fruiting bodies of these species are pretty heavy. If I can find a decent supply I will usually harvest enough for two years so that I don't have to harvest it every year. However, this year I couldn't find much good quality artist's conk. I had one litre of the Ganoderma mixture pressed and another litre of this species on hand macerating. I was able to find just enough to make another two litres. Fortunately, I only needed to find one good sized conk to make this amount.

The fruiting of many fungi species is variable. It is particularly influenced by the amount of available moisture. In some years certain fungi may not fruit at all if there isn't enough rain. For instance, a couple of years ago it was very dry in Southern Ontario and the artist's conk, hemlock varnish shelf and birch polypore (Piptoporus betulinus) in the woods around my home didn't fruit at all. But the birch polypore, which typically fruits in August or September, finally did fruit during a thaw in mid January!

A new fruiting of artist's conk (with a friend hiding beneath!).

The new growth along the margin of a fruiting body looks white and rubbery, similar to the appearance of the underside. As it reaches the limits of its new growth it transforms into its typical woody appearance as the white band along the edge gets increasingly narrower until it finally disappears. The spores are released from pores in the underside, which is why it is called a polypore. Apparently the top and underside of the fruiting body have an opposite electrical charge. As a result, some of the spores when they are released are attracted to the top of the fungus. During the peak of its fertile period there is often a deposit of the brownish dusty spores on top of artist's conk.

Another friend: This wood frog (Rana sylvatica) was nearby watching the strange dude photographing fungi!

There is a brief overlap between the period of active growth and the fertile period when spores are produced. This is when I prefer to harvest it. At that point there will still be a very narrow white growth band along the rim, but there will already be a light dusting of spores on top unless it has been fairly breezy. Since the growth of this species is so variable, the point where it is at this stage can be anywhere from mid June to early August in southern and central Ontario. This year I harvested artist's conk on July 12th. It was a bit more mature than when I usually harvest it. The first week of July would have been ideal.

I have found that it is best to only harvest the part of the conk that grew during the current year and the previous year or two. The portion that grew each year can be easily determined by the distinctive growth bands on the upper surface. When it is harvested this way it will continue to grow in the following years.

Sometimes artist's conk grows more vertically and the growth bands are layered on top of each other.
On this one the dusting of spores is visible on the upper surface.

The harvested portion of artist's conk. The yellow stain on the cutting board was from processing
fresh organic turmeric rhizome (Curcuma longa) a few weeks previously.

The underside of the same piece. The discoloration on the lower part is bruising caused
by my fingers when I was holding it while cutting it with my knife.

When we harvest the previous three years of growth, there will often be a portion of the upper surface from two years prior to the year it is harvested that is old and dying. This oldest layer is removed. This is best done with a good heavy-bladed knife like a cleaver or sometimes a serrated knife will work well.

You can see the distinctive growth bands layered vertically in this cross-section.
The upper layer that has lots of white in it is too old and must be removed.

Here's the same piece from above after the older tissue was removed.

Once the older tissue is removed, there are two stages in processing artist's conk to prepare it for making a maceration. It is not possible to immediately start chopping it with a mezzaluna  because the fruiting body has a dense but somewhat rubbery quality. It gives too much to be cut in this way. It is necessary to slice it up into smaller pieces first. The same kind of knife we used to remove the older tissue will work well for this.

Artist's conk after the initial cutting.

Once the pieces are small enough, they can be chopped finer with the mezzaluna. This is much quicker than doing it with the cleaver.

Here it is again after the final chopping.

Some fungi absorb a lot of water. This needs to be considered in terms of how we prepare a tincture because the water content will dilute the constituents in the tincture. Because of this I will step up the potency of these fungi one level. Whereas I primarily recommend preparing a 1:5 maceration (1 part herb to 5 parts menstruum) for fresh herbs, for really wet fungi I will prepare a 1:4 maceration. However, this will further increase the amount of water in the tincture. In order to compensate for this I need to adjust the menstruum as well. For dried herbs I usually use a menstruum consisting of 60% water, 30% alcohol and 10% glycerin. For fresh herbs I increase the concentration of the alcohol and glycerin slightly to compensate for their water content. The ratio I use is 56% water, 33% alcohol and 11% glycerin. Since I primarily use fresh herbs, it is the latter mentruum that I use most of the time. However, with really moist fungi I adjust it further to 52% water, 36% alcohol and 12% glycerin. Hemlock varnish shelf and birch polypore fall into this category, but there are other fungi, such as clinker polypore (Inonotus obliquus), better know as chaga, that are no more moist than the average herb. In the latter case no adjustment of the potency or menstruum is necessary. Artist's conk tends to fall into the middle. If there has been a lot of rain it can be fairly moist, however, sometimes it isn't. Each time I make it I have to decide whether or not it is necessary to compensate for the moisture level.

I have covered the specifics of making a maceration of a fungus like artist's conk. For other more general details on the process of making a tincture, see the Making Medicine series of posts.

Ground ivy is a moderately aromatic herb. Its relatively mild flavour is somewhat minty and musky with just a touch of bitterness. If I have any left over I will dry it and use it to make a tea. I like the taste of ground ivy but some people find it a bit unpleasant. However, it is not overpowering and blends well with many other aromatic herbs.

Many medicinal fungi are moderately to significantly adaptogenic. Although every adaptogenic herb has some specific areas of use, adaptogens also work as general tonics and tend to have benefits for our whole body. However, I have found that for people suffering from chronic health conditions, in order to get the most out of using adaptogens it is best if they are used in the final stages of treatment where they have both specific and generalized actions and help to coordinate the functioning of the different systems of our body. They can also be used as general tonics by people who are relatively healthy.

I have found that the adaptogenic fungi are a little bit different than some of the more purely adaptogenic herbs like American ginseng (Panax quinquefolius). Whereas ginseng works best in a purely adaptogenic formulation, fungi such as artist's conk are excellent transitionary herbs. I use them in formulations at the stage when I am transitioning a person from some other kind of formulation into the final adaptogenic stage of treatment, as well as in more purely adaptogenic formulations.

That's all I'm going to say about the properties of artist's conk. In the Herbal Resources section of my website I have provided a pdf document that you can download that is based on my research and experience with this herb.

Link to PDF file.


Saturday, July 13, 2013

The Milk Myth

When I was growing up, milk and other dairy products were considered to be among the healthiest of foods. Kids, in particular, were encouraged to drink milk liberally. It was even considered to be healthier for babies than their mother's milk and breastfeeding was generally discouraged. This was largely in response to the propaganda machine of the dairy industry which targeted parents, doctors, and heavily lobbied governments to make sure that milk was on the top of the list of healthy food choices in their various official food guides. Our society was a lot more patriarchal in those days and almost no one would ever question someone in authority like a doctor. So, if your doctor told you not to nurse your baby and put her/him on a dairy-based infant formula instead, and all through their childhood and adolescence to make sure they drank lots of the white stuff, that was what you did. It didn't matter that doctors received extremely little, if any, schooling in nutrition (not that it would have mattered much as there was very little good science behind nutrition until the last 10-20 years). They were the experts!

When it comes down to it, most doctors, even if they are among the few who are more open-minded and less stuck in a narrow reductionistic paradigm, really don't have a lot of time to keep on top of the latest research. As a result, they get most of their info from product literature provided by pharmaceutical companies and other commercial interests. Of course they have the Canadian and American Food Guides to fall back on when it comes to nutrition. But these are hugely influenced by lobbying efforts on behalf of major commercial sectors such as the dairy and meat industries.

Now, to be fair, the natural health product industry plays the same game, although they don't have the size, money and influence to do it as well as the larger, better established industries. If you go looking for information from people who work in health food stores or from many natural health practitioners (especially if they sell products), no matter how good their intentions you'll find that they are getting most of their information from biased product literature provided by the natural health product industry.


Anyway, getting back to milk, until recently most of the research out there was largely funded by the dairy industry. However, more recently there have been some decent independent studies that have been coming to very different conclusions than what the dairy industry would like us to believe. As a result, some pretty high profile researchers have begun to poke holes into some of the milk myths. For instance, see:

http://blogs.scientificamerican.com/talking-back/2013/07/03/got-milk-maybe-a-recipe-for-obesity-and-cancer/

Some of the myths that are questioned here are: skim milk is healthier than whole milk; milk is the best source of calcium; most of the supposed health benefits of milk are unproven. They also point out that milk consumption is associated with a number of potential negative health consequences and recommend that whole milk be consumed rather than skim milk and it should be considered an optional part of our diet (no minimum daily requirement as the various official food guides recommend) and consumed in small quantities, if at all.

I would add to that to only consume certified organic dairy products. It's interesting that many people are more inclined to purchase organic fruits and veggies but aren't as concerned about dairy and meat products. The rationale is that chemicals are sprayed directly on to plants, but this is not the case with animals. I'm sure cost is one of the factors behind these attitudes. Dairy and meat tend to be among the more costly food products and when you add the organic premium they can get pretty expensive. My answer to that is to buy organic but eat less. Most North Americans eat far too much meat and dairy anyway. Aside from the fact that commercially raised animals are unhealthy from being stressed out, fed diets that are unnatural for their species, being raised in inhumane conditions, and pumped full of drugs and hormones, toxins such as agricultural chemicals become more concentrated as you move up the food chain. Although it varies depending on the chemical and the animal, on average it is about ten times at each level. That means that, since commercially raised livestock are fed commercially grown feed, the levels of agricultural chemicals in the tissues of these animals is approximately ten times the level of the plants that they are fed. Also, many animals (even herbivores) are given feed that contains animal products which will raise the levels of these chemicals in their tissues to even more than ten times. As a result, animal products are the most important foods to eat certified organic!

Dandelion greens (Taraxacum officinale) are an excellent source of calcium,
magnesium, potassium, iron and other important trace minerals.

Getting back to milk, the dairy is the best source of calcium myth is being questioned as well. For instance, apparently bone fractures are more common in countries that have the highest dairy consumption! The authors point out that significant levels of calcium can also be obtained from leafy greens, nuts and seeds. Many herbs are a good source of calcium as well as other minerals that are necessary for the proper assimilation and utilization of calcium. These include the leaves of dandelion (Taraxacum officinale), chicory (Cichorium intybus) and nettle (Urtica dioica). Although I usually prefer to use herbs in the form of fresh plant tinctures for medicinal purposes, when they are being used for their nutritive properties it is best to take them as a tea because the amount of actual herb per unit dose is much higher to make a cup of tea than what is necessary for a dose of tincture. Most nutrients need to be consumed in much larger quantities than other more pharmacological constituents of herbs. Of course, you'll get even more minerals and other nutrients if you eat them! Many green leafy herbs are both edible and very nutritious.

Although calcium is a very important nutrient, the whole issue of how much we need is now being questioned as well. Some recent research has demonstrated that too much calcium is associated with negative health consequences, especially cardiovascular disease. For instance, check these out:

http://www.sciencedaily.com/releases/2013/02/130212192030.htm

http://www.sciencedaily.com/releases/2013/02/130204184306.htm

I included both of them because although one of the studies only found this association in men, but not women, the other one focused exclusively on women. It is interesting to note that there seems to be a stronger correlation when people take calcium supplements. It would have been interesting to see what they would have found had they taken into account the different forms of calcium that were supplemented.

Our obsession with calcium is one of the factors behind the recommendation to consume more dairy products. However, we seem to be getting carried away with this. Calcium supplements are one of the most common supplements recommended by doctors.

When I see new clients, I am often shocked at how much calcium they have been told to supplement by doctors and even other natural health practitioners. I often see people taking 50-100% the recommended daily amount. This is absurd! It is true that our body does not absorb 100% of the calcium we consume, however, the efficiency of calcium absorption increases the more we need it. It is also true that calcium levels are only high in a small percentage of foods, nevertheless there is calcium in everything that we eat (except in some heavily processed junk foods and beverages). In addition, doctors in particular often recommend the worst calcium supplements. Firstly, they recommend forms that are poorly absorbed such as calcium carbonate, which is the most common form found in pharmaceutical brands. Secondly, they often recommend supplements that only contain calcium and possibly some vitamin D. The latter is necessary for proper calcium absorption. Most calcium supplements contain 200-400 IU of vitamin D. Recent research has demonstrated that many people are deficient in vitamin D, so these amounts are not enough for most people. In addition, our body has to maintain a very delicate balance between many minerals. If some minerals are taken in excess it disturbs this balance, both by the increased availability of the supplemented minerals, and because excessive intake of some minerals will actually deplete our body of others. As a result, calcium should not be taken on its own. Ideally, at the very least it should be taken with vitamin D, magnesium, zinc and copper, but preferably with manganese, silicon and possibly a few other trace minerals as well. Usually the best way to take calcium is as part of a good multi mineral complex.

Here I am hugging a dolomite (dolostone) boulder. Dolomite is one of the sources of calcium carbonate.
I don't know about you, but I don't absorb rocks very well. However, I do enjoy hanging out with them!

In my practice, I rarely recommend calcium. If someone is a bit low in this mineral, it can usually be addressed through diet - even without dairy products. In some situations and for therapeutic purposes I may recommend it, but rarely more than 200-300 mg per day, always in a well absorbed form such as calcium citrate or ascorbate, and always in combination with a decent amount of vitamin D (at least 1,000 IU) and other minerals to balance things out.

So, lets get back to milk and other dairy products. Dairy is one of the most common food allergies or sensitivities in our society. This is related to a lot of factors that are common in our society: poor diet and lifestyle practices; lack of exercise; general toxicity; stress and other emotional and psychological factors. All of these predispose us to many chronic health conditions including allergies and food sensitivities. Add to this that most of the dairy products we consume come from sick animals; are laced with drugs, hormones, agricultural chemicals and other toxins; and that milk by nature contains proteins that are irritating to our digestive tract and, in general, is over-consumed (we are more likely to develop sensitivities to foods that we consume in excess), and it's not surprising that so many people don't tolerate it well or at all. In my practice I often find dairy allergies or sensitivities associated with obesity, diabetes, and chronic inflammatory conditions of the digestive tract, skin and respiratory system. As a result, I usually have people with these kinds of conditions reduce or even eliminate dairy from their diet, depending on the individual case.

One interesting side note, in ayurvedic and siddha medicine, two ancient healing traditions from India, they extol the benefits of milk, considering it to be one of the most perfect foods. They sometimes even recommend that herbs be boiled in milk! I once had a conversation with an ayurvedic practitioner about this. I explained that I so often see milk consumption associated with chronic health conditions. It was his belief that this is because the milk we consume in the West is from sick animals, full of chemicals, pasteurized and refrigerated. He believed that the processes of pasteurization and refrigeration denature (alter the structure of) the proteins in milk making it more harmful than beneficial. I don't know if this is true, but it's something worth considering. In India, until recently, very few people had refrigeration. They usually obtained their milk fresh each day from free ranging cattle, boiled it and either used it right away or cultured it to make curd. When I was in India in the early 80's, I still had a very severe allergy to dairy products (which I eventually overcame). Although I could not tolerate dairy products in any quantity when I was at home in Canada, I could tolerate them in small amounts over there. Apparently, there is (or was) something very different about their dairy products.

Many people in India obtain their milk from Brahma cattle (Bos indicus).
Of course, you won't get much milk from this one!

The bottom line here is that milk and other dairy products are not as beneficial as they are promoted to be; are particularly problematic for a growing segment of our population who have various kinds of sensitivities to them; and can have some serious negative health consequences when over-consumed. For those who can tolerate them, it is best to consume only certified organic dairy products, and only in moderation.


Thursday, July 4, 2013

Harvesting Ground Ivy

On June 12th I went to one of the areas where I wild-harvest herbs and harvested ground ivy (Glechoma hederacea), better know as creeping Charlie in some areas. This Eurasian species has naturalize throughout much of North America. Some people consider it invasive, especially in shady areas, but it really isn't. It can sometimes be prolific, but it doesn't crowd out other species. It often grows on shadier parts of lawns. If you notice a somewhat minty smell when you are mowing the lawn, you've probable mowed some ground ivy!

This is an herb that I use in moderate quantities in my practice - typically about 4-5 litres per year. It is a very versatile herb and I would probably use even more of it if it wasn't for the fact that it is a difficult herb to harvest in quantity due to its small size. As I still had 2 litres of ground ivy macerating and a bit more already pressed, this year I harvested 5 litres. With herbs that I use in small to moderate quantities I usually harvest a two year supply so that I only have to harvest about half of them each year, but because of difficulty harvesting large quantities of this herb it is necessary for me to harvest it annually.

Ground ivy (Glechoma hederacea) in the early spring before it starts to produce flowering stalks.
The larger, older looking leaves are the ones that have over-wintered.

Ground ivy is fairly sensitive to variations in weather conditions from year to year. In the region where I live it can go into flower any time from mid April to early May. It has a relatively long flowering period, typically flowering until late June or early July.

Although we tend to harvest the aerial parts of most herbs very soon after they go into flower, with ground ivy it is preferable to wait until a bit after the middle of its flowering period. This is because the flowering stalks that we harvest are relatively small and don't weigh very much. It is best to wait until they are almost at their maximum height. I usually harvest it from early to mid June, depending on the weather conditions in any given year.

The young stalks of ground ivy just before it begins to flower.

Fortunately ground ivy has a fairly long period when it can be harvested - typically about two weeks - because, with the unusually cool, wet weather we have been having, there haven't been very many days when the conditions are ideal for harvesting herbs. As a result, I didn't get a few of the herbs that I intended to harvest; but I had to get ground ivy because I use a fair amount of it.

This is what ground ivy looks like when it first goes into flower.

Last year the conditions were the opposite of this year. They were unusually hot and dry. As a result, I harvested ground ivy earlier; on June 5th. It was actually about a week later in its life cycle when I harvested it last year. Had I harvested it at a similar stage to when I harvested it this year it probably would have been about a week earlier, more like the end of May.

Here is ground ivy a few weeks later.

This year on June 12th I headed out to a wilderness area about 15 minutes from where I live to harvest ground ivy. As always, I began by offering tobacco to the spirits of the land and the medicine and asking permission to harvest the medicine that day. After I received permission I headed to an area where the spirit of ground ivy is very strong and there is a large healthy population.

A closer look at our friend. Notice that it has square stalks and opposite leaves, typical of the Mint family.

Although for the most part our spring was cool and wet, we did have a few short periods when it was sunny, hot and humid. The day I harvested ground ivy was during one of those periods. It was very hot that day and I had to be careful not to drip sweat onto the herbs as I harvested them. It was also the first day when the mosquito people were quite present. I rarely use mosquito repellent and only use a natural formulation that I make when I do. However, I never use repellent when I am harvesting herbs. Partly it is to ensure that the essential oils in the repellent I use don't contaminate the herb(s) that I am harvesting. But it is also another way that I give back to the land where I am harvesting. I never intentionally kill biting insects and when I am harvesting I just let them bite me. Eventually my blood will work its way up the food chain, into the soil, and even the plants that live there. The the sacrifice of the plant people when they offer the gift of their medicines is far greater than the little bit of blood that the mosquitoes take from me. In fact, I have a good relationship with the mosquito people and they bite me a lot less than they bite other people. When I'm with other people they hardly bite me at all, unfortunately for the others! When I used to have a more antagonistic attitude towards them they used to bite me as much as anyone else.

The flowering stalks of ground ivy can grow up to 50-60 cm (20-24 inches) tall, but it is best to harvest them when they are about 30-40 cm (12-16 inches) tall. We harvest about the terminal 50% of the stalk. In order to ensure that I do not have too much of an impact on the local population of this herb, I only harvest about from about a third of the stalks in any given area.

The harvested portion of two different size flowering stalks. The top one is 20 cm (8 inches) long,
the bottom one is 15 cm (6 inches).

In preparing herbs to make a tincture there are two stages that can be relatively time consuming. The first is the actual harvesting. Plants for which the harvested portion is small or whose population tends to be more spread out take a lot more time. Of course, we have to include the time it takes to travel to and from the area where we are harvesting as well.

The other stage that can be time consuming is the processing that we need to do with the harvested portion before it can be chopped up to prepare a maceration. There are some herbs from which we use the entire harvested portion. However, these are the minority. With the aerial parts of most herbs, much of the stalk is a fair bit less potent than the leaves and flowers. As a result, we usually have to remove a portion of the stalk. The difference in potency between the stalk and the leaves and flowers varies from herb to herb. The greater the difference, the greater the proportion of stalk that has to be removed and the longer the amount of time it takes to process the harvested portion. The more an herb branches, the more time this takes as well. Ground ivy is about medium in this regard. We do need to remove a fair bit of the stalk, but the stalks do not branch. With this herb it is best to remove the leaves and flowers from about the lower 2/3 of the the stalk. That portion of the stalk is removed and not used. I don't waste anything. The discarded stalks end up in my composter. If I didn't have a composter I would return them to the Earth somewhere at my next opportunity.

The same two harvested portions showing the amount of stalk that was removed.

Once the stalk that we aren't using is removed, the herb is weighed to determine the appropriate amount we need to use taking into account the potency we wish to prepare and the size of the jar that we will be macerating it in.

This is the amount of processed herb required to make 1 litre of tincture at a 1:5 potency.

Then we have to chop the herb up relatively fine before it can be macerated. With the right tools, that doesn't take very long. For more information on the specifics of making a tincture, see the Making Medicine series of posts.

Here it is again, chopped up and ready to macerate.

Ground ivy is a moderately aromatic herb. Its relatively mild flavour is somewhat minty and musky with just a touch of bitterness. If I have any left over I will dry it and use it to make a tea. I like the taste of ground ivy but some people find it a bit unpleasant. However, it is not overpowering and blends well with many other aromatic herbs.

There is not very much information on ground ivy out there. It is primarily recommended for respiratory conditions and inflammation and ulcers of the digestive tract. In my experience, I have found it to be a much more versatile herb than what you might suspect based on the information in the literature. However, this is typical. When I use an herb and really get to know it, I always find that it has many more properties and uses than what is indicated in the literature.

Rather than turn this into a super long post by getting into the uses of ground ivy, in the Herbal Resources section of my website I have provided a pdf document on ground ivy that you can download that is based on my research and experience with this herb.

Link to PDF file.

So, that wraps up my discussion of my experience harvesting my friend and colleague ground ivy. Except for the difference of habitat, the process is very similar to harvesting blue vervain (Verbena hastata), which I described in the Making Medicine series. In future posts I will discuss the harvesting and processing some different medicines that have a range of different requirements.


Thursday, June 27, 2013

Harvesting Herbs: Dancing With Weather

OK, I'm back! I haven't posted anything since I returned from my back-to-back trips to Mexico and Lake Superior - and, yes, my leg is doing great! I'll provide more on that in a future post.

Unlike last year, during which the warm weather came very early in the spring and the spring and first half of summer were extremely hot and dry, so far this year it has been unusually cool and wet in the region where I live. This can have a significant influence on many plant species. Each plant has an ideal habitat that it prefers, including type of soil, moisture level, amount of sun, and climatic conditions. However, there will be a range of conditions in which it can do well and a wider range of conditions that it can tolerate. What these conditions are and how much variation it can tolerate will vary from plant to plant.

The plant life in my area can be pretty lush when there is lots of moisture like there is this year.

There is always a certain amount of climatic variation in any given region. The amount of variation in the Great Lakes region where I live is probably moderate compared to other regions. However, since around 1970 our climate has been noticeably changing - and the amount of change has been increasing with each successive decade. The kind of change is consistent with what we can expect given global trends: a progressive warming with greater extremes. This has had a noticeable impact on plant and animal species.

So, let's get back to the conditions this year. It is fortunate that, although it has been cooler and wetter, we have at least had one or two sunny days most weeks and even on some of the days that it has rained there have been sunny breaks at some point during the day. As a result, some plants that do very poorly if there has been very little sun are managing to stay relatively healthy.

Many plants that don't do well if there is too much rain and too little sunshine are still doing fairly well this year.

On the other hand, there are a few plants that are looking a bit stressed. This is particularly the case for plants, such as a few of the bedstraw (Galium) species, that grow in lower light areas that are relatively moist. Examples include cleavers (G. aparine) and rough bedstraw (G. asprellum). When there is as much rain as we have been getting this year, the typically moist areas where some of these species grow tend to be moist to the point where they are somewhat wet - and not all plants that grow in these areas necessarily like wet conditions.

Rough bedstraw (Galium asprellum) is finding many of the areas where it lives too wet this year.

As an herbalist that wild-harvests almost all of the medicines that I work with, years when it is very cloudy, rainy and cool can be challenging in a couple of ways. Firstly, most herbs need to be harvested on a sunny day and there needs to be at least one additional sunny day between the day they are harvested and the last rain. For some plants there needs to be two sunny days in between. This is because the plant tissues tend to otherwise be too wet and there are many important constituents, such the components of essential oils, that are produced in much lower quantities if there isn't much sunshine. If there are too few consistent periods of sufficient sunshine, there are also a lot fewer days when herbs can be harvested. If the timing of the sunnier periods doesn't line up with when the herbs are ready to be harvested, I may not get some herbs that year. Secondly, there are some plants, such as red clover (Trifolium pratense) and common St. Johnswort (Hypericum perforatum) that are significantly less potent during such conditions to the point where it isn't even worth harvesting them. In unusually wet (and dry!) years many plants will also be affected by mildew, making them unusable.

Red clover (Trifolium pratense) isn't happy when it's too cloudy and wet!

When the conditions are cooler, cloudier and/or wetter than usual, it is best to harvest herbs in the sunnier parts of their range where they will get maximum direct sun and the soil will be a little bit drier. In years when it is hotter, sunnier and/or drier than usual, it is best to harvest herbs in the shadier parts of their range where they are more protected from excessive sunshine and the soil will be more moist. This year, herbs such as stinging nettle (Urtica dioica), which can tolerate full sun but doesn't usually do well in it, is doing very well in more open areas.

Our native stinging nettle (Urtica dioica ssp. gracilis) is doing very well this year in more open areas.

I typically spend about one day per week harvesting the medicines from mid April to mid May; two days per week from mid May to mid June; three days per week from mid June to the end of July; two days per week in August; one day per week in September; I only harvest on two to three days in October; and then it's back up to two days per week in November. This means that during harvesting season I have to minimize the amount of days that I have a fixed schedule, such as clinic days and scheduled classes and workshops. Which days I need to harvest on depends on when the herbs reach the right stage in their life cycle for harvesting and, of course, the weather! During the peak harvesting season I do my best to allow four to five days per week when I have nothing in particular scheduled so that I can head out on a moments notice whenever the herbs and the weather align! Fortunately, a lot of the work that I do can be scheduled around my harvesting days.

This intensive harvesting schedule means that if I harvest almost all of the herbs I use and don't cut any corners to ensure that the medicines are harvested in a respectful and ecologically sustainable way, and are the highest quality possible, I can only harvest and prepare enough medicines to comfortably run clinics two days per week scheduling about five to seven clients per day. I could maybe do three days per week if I really push it, but I would rather not. These constraints are fine with me. Healing work is very intensive. If one gives oneself fully to the medicine it is very difficult to be completely present when seeing more than 15-20 clients per week. It is essential that any healer live a balanced life and look after their own health and well-being in order to be able to fully live the medicine and offer the most to those who need it.

In my practice I only run clinics one day per week. The rest of the time I do other related work such as teaching, writing, and dealing with the various responsibilities I have as a result of being on the board of directors of both our provincial and national herbalist associations. For almost two years a lot of my time has also been devoted to converting the content of courses to an online format. This will continue for a couple of years, but out of necessity it slows down during harvesting season. By nature I do best with diversity and flexibility. My work also requires that I spend regular time deepening my relationship with Nature and the medicines, whether I'm out there observing or just being.

In years where the weather conditions verge towards the extremes it can make harvesting difficult. For instance, of the sixteen herbs that I had intended to harvest this spring, I only managed to harvest ten of them. Fortunately, I didn't need as many herbs as usual. This is partly because I will often harvest enough to prepare a two year supply of tincture for herbs that I use in low to moderate quantities so that I don't have to harvest every herb that I use every year. For herbs that I use in larger quantities this isn't possible. Also, last year I used less of some of the spring herbs than usual.

 American black elder (Sambucus nigra ssp. canadensis) is right on schedule this year!

Another challenge associated with more extreme weather conditions is that it can significantly alter the life cycle of a plant. Although the timing of some species such as black elder (Sambucus nigra) and yarrow (Achillea millefolium) is pretty consistent from year to year, others can vary by as much as one to four weeks depending on the weather.

This year lance-leaved heal-all (Prunella vulgaris ssp. lanceolata) came into flower sixteen days later than last year.

Ultimately, all I can do is surrender! Herbalists have always had to learn to work with whatever Nature provides. Fortunately, I work with enough medicines that if I can't harvest a sufficient quantity (or any!) of a particular herb in any given year I usually have one or more herbs that are similar enough that I can use as a substitute. In the mean time, looking ahead at the coming weeks there is still lots of rain in the forecast. In terms of the rest of the harvesting season, I'll just have to wait and see how the summer is going to unfold. All I know for sure is it will be an adventure!


Saturday, April 20, 2013

Healing Bone Fractures, Part 5 of 5


This is the fifth in a series of posts in which I am documenting the process of treating a serious fracture of my right leg. In Part 1 I discussed the details behind the injury and the initial protocols that I used with the remedies I had available while I was still away. In Part 2 I provided a detailed account of the protocols that I implemented when I returned home. In the remainder of the posts I am providing an update on how things are progressing and any modifications that I have made to the protocols that I am using.

At this time I have to report that my leg is healing amazingly well. Since my last post I gradually increased the amount of weight I was carrying with my injured leg while still walking with crutches. On April 7th, about nine and a half weeks after my surgery, I walked without crutches for the first time! It kind of happened spontaneously while we were sitting around a fire. After that I increased the amount that I was walking without crutches each day. On April 10th I drove for the first time. I purchased a cane that day because I had to drive into Toronto on the evenings of the 11th and 12th and I knew I would be walking quite a bit. I thought I might need to use it for awhile, but except for those two evenings, I haven't used it since. On those two days I didn't use my crutches at all during the day except when I took my dogs for a walk in the woods. On the 13th I walked them for the first time without crutches and I have been crutch free ever since! This is pretty amazing given that the original prognosis was that I wouldn't be able to even begin to put weight on my leg until the middle to end of May. My healing process is about eight weeks ahead of schedule. Thank you plant people!


The "complications" that I discussed in my last post are pretty much resolved. I got rid of the remaining infection underneath one of the scabs on my incision. The astringed skin still isn't completely back to normal. It takes quite awhile for the skin to completely heal when the deeper dermal tissues get astringed, so am still applying things to this area at a minimum.

I had another x-ray this past week and the slightly darker area in my lower tibia below the bottom portion of the metal plate is still there, but not as dark as before. The surgeon can't explain it, but it isn't as noticeable as last time and, based on everything else, an infection in my bone has been pretty much ruled out. There is still a moderate amount of swelling around my ankle, although it is improving, but this is not due to infection. It turns out I have a pretty badly sprained ankle. This is typical with the kind of injury that I have. At this point my bone is doing fine and it is the sprain that is giving me the most difficulty. I still can only stretch my ankle about 80% of its normal range. It's a bit painful when I walk and it causes me to walk with a slight limp. However, I still refused the anti-inflammatories and ankle brace that the surgeon suggested. I've been doing some additional kinds of stretches with my ankle and in the last two days it has improved a fair bit. Today I had almost no limp even when I was walking my dogs. Tomorrow I have to teach a six and a half hour field workshop out in the woods. We'll see how well I hold up with that one! On Wednesday I'm off to Mexico for a week and a half, then I'm back for a day and off to Lake Superior for another week. This is part of my work, not a holiday. I am very grateful to be able to go as it was looking unlikely right after my injury. It will probably be awhile before I can run or carry a heavy pack, but otherwise my life is pretty much back to normal!

So here are the changes to the protocols that I have been using:

Systemic Herbal Formulation: In Part 4 of this series I provided the details of the third and fourth systemic formulations that I used. At about the nine week point the fourth formula ran out. The fifth version of the formulation contained wild bergamot herb (Monarda fistulosa) 20%, boneset herb (Eupatorium perfoliatum) 20%, common comfrey herb (Symphytum officinale) 18%, wood nettle herb (Laportea canadensis) 15%, maidenhair tree leaf (Ginkgo biloba) 15%, turmeric rhizome (Curcuma longa) 10%, and white pine leaf/twig (Pinus strobus) 2%. I added the wild bergamot because of the risk of infection in my tibia. It is an excellent herb for circulation and inflammation, but it is also an amazing antimicrobial. Yesterday I ran out of my fifth formulation and once more I made a slight change, substituting common burdock herb (Arctium minus) for boneset, and reintroducing stinging nettle herb (Urtica dioica) instead of wood nettle. Otherwise the formulation is the same. These changes were primarily implemented to prevent my body from getting too used to the formulation. I am continuing to take 6 ml three times per day on an empty stomach, 5-10 minutes before each meal.

Wild bergamot (Monarda fistulosa), my dear friend and colleague!

Herbal Sleep Formulation: I have been sleeping great, but probably not enough because most nights I have been working late. To support my healing process by making sure that I continue to get good sleep, I am still taking 0.75 mg of melatonin and an herbal sleep formulation when I go to bed. I have made additional adjustments to my sleep formulation so that my body doesn't get used to it and it continues to be somewhat coordinated (overlapping) with my daytime formulation. I have made two additional sleep formulations since my last post coinciding with the two most recent systemic formulations for my leg. The first one contained English lavender flowering spike (Lavandula angustifolia) 20%, wood nettle herb (Laportea canadensis) 20%, St. Johnswort herb (Hypericum perforatum) 20%, common comfrey herb (Symphytum officinale) 15%, hop strobilus (Humulus lupulus) 15%, wild bergamot herb (Monarda fistulosa) 9%, white pine leaf/twig (Pinus strobus) 1%. The most recent one that I prepared a couple of days ago contains English lavender 20%, stinging nettle 20%, St. Johnswort 20%, hop 20%, common comfrey 10%, wild bergamot 9%, white pine 1%. I am continuing to take 6 ml immediately before bed. Very rarely I've needed to take an additional 3 ml dose when I've woken up at the crack of dawn and had difficulty falling back asleep.

Homeopathic Remedies: I am continuing to take the same homeopathic remedies that I indicated I was using in Part 3.

Supplements: I am continuing to take the same supplements that I indicated in Part 2 except, as I mentioned in Part 4, I no longer need to take probiotics.

Topical Herbal Preparations: As I mentioned above, the infection underneath a scab that I discussed in Part 4 is gone, but the skin around my incision is still a bit astringed from doing too many poultices. As a result, I've had to cut back further on the topical preparations compared to what I was doing before. In spite of this, I have hardly any scar! Here's what I am currently doing:
  • When I wake up I apply the liniment I am using (see Part 2) to my whole lower leg up to and including my knee, but not to the area of the incisions themselves. I actually ran out of the liniment and made a new batch. It has the same essential oils in roughly the same proportions, but I increased the potency to 3 drops per ml of base oil and the base oil is now 2/3 the infused oil I have been using and 1/3 castor bean oil (Ricinus communis). I made these changes because I was concerned about the possibility of an infection in my lower tibia. This has now been ruled out, but I am continuing to use the higher potency liniment to help address my sprained ankle. I do not apply anything to the area of my skin around the scar that is still somewhat astringed.
  • In the evening before I go to bed I reapply the liniment as in the morning, but this time I apply castor oil to the astringed areas of my skin. This has been an interesting experiment because I haven't really used castor oil before. Nevertheless, I know a couple of people who have had great success treating bone fractures almost exclusively with castor oil packs. The castor oil is very drawing and it is accelerating the exfoliation of the dry scaly skin. However, it is also slightly astringent. Initially I tried applying it twice per day and it actually aggravated the astringed skin a bit. I've found once per day to be working much better. Once the astringed skin heals, I will go back to applying Monika's scar ointment to the area of the incision (see Part 4).

Castor bean oil (Ricinus communis) has many healing properties.
It can also help reduce infections deep in the tissues.

So there you have it! Needless to say, I'm very happy with how things are going. No matter how much we think we know, healing is still a very powerful and mysterious thing. It never ceases to amaze me, whether I'm experiencing it first hand or supporting other people with their healing process.

I'm going to be out of commission for the next few weeks as I will be off working in Mexico and then near Lake Superior. I will report on how my leg holds out when I get back ... and then maybe it will be time to write about something else. Enjoy the spring (or fall if you live in the deep south)!


Wednesday, April 3, 2013

Healing Bone Fractures, Part 4 of 5


This is the fourth in a series of posts in which I am documenting the process of treating a serious fracture of my right leg. In Part 1 I discussed the details behind the injury and the initial protocols that I used with the remedies I had available while I was still away. In Part 2 I provided a detailed account of the protocols that I implemented when I returned home. In the remainder of the posts I am providing an update on how things are progressing and any modifications that I have made to the protocols that I am using.

Overall, things have been going well, specifically with regard to the healing of my fractures. My leg is strong and I am well ahead of schedule. However, there have been a couple of unexpected complications relating to other aspects of my healing process which I will document below. I will begin with adjustments to the remedies and protocols that I am using.

Systemic Herbal Formulation: In Part 3 of this series I provided the details of the second systemic formulation that I began using about 3 weeks after my surgery. At about the 5 week point the second formulation ran out and once more I decided to make a slight change to the formula. While maintaining the focus on healing my bone fractures, I wanted to increase the emphasis on improving circulation to help further compensate for my lack of movement which was still resulting in a fair amount of blood pooling in my foot. At that time I only made a slight change, substituting rosemary (Rosmarinus officinalis) for wild ginger (Asarum canadense). I made additional changes at the 7 week point when I prepared my fourth formulation, replacing American plantain (Plantago rugelii) with maidenhair tree (Ginkgo biloba) and stinging nettle (Urtica dioica) with wood nettle (Laportea canadensis). The fourth version of the formulation contains wood nettle herb (Laportea canadensis) 20%, boneset herb (Eupatorium perfoliatum) 20%, common comfrey herb (Symphytum officinale) 20%, maidenhair tree leaf (Ginkgo biloba) 18%, turmeric rhizome (Curcuma longa) 10%, rosemary herb (Rosmarinus officinalis) 10%, and white pine leaf/twig (Pinus strobus) 2%. I am continuing to take 6 ml three times per day on an empty stomach, 5-10 minutes before each meal.

Wood nettle (Laportea canadensis) is rarely mentioned in the herbal literature.
Its properties are similar to stinging nettle (Urtica dioica) but a bit more diverse.

Herbal Sleep Formulation: My sleep has been very good since my last post four weeks ago. Beginning a few days after I posted Part 3, I was able to gradually start shifting slightly onto my right side, which made it easier for me to sleep. For the last two weeks I have been able to sleep completely on my right side without any discomfort. However, I still can't lie on my left side for more than 10-15 minutes before my leg starts to get uncomfortable as there is pressure directly on the plate and screws in my leg. It doesn't hurt, it just doesn't feel good. At this point I am sleeping mostly on my right side and shifting onto my back or left side for short periods a few times per night when my body starts to stiffen up. Because of the importance of getting good sleep to facilitate my healing process, I am still taking 0.75 mg of melatonin and an herbal sleep formulation when I go to bed. Due to the additional changes to my primary systemic formulation, once more I made a slight adjustment to the sleep formulation as well so that the two formulations remain well coordinated. It now contains English lavender flowering spike (Lavandula angustifolia) 20%, wood nettle herb (Laportea canadensis) 20%, St. Johnswort herb (Hypericum perforatum) 15%, German chamomile flowering top (Matricaria recutita) 15%, common comfrey herb (Symphytum officinale) 10%, hop strobilus (Humulus lupulus) 10%, turmeric rhizome (Curcuma longa) 9%, white pine leaf/twig (Pinus strobus) 1%. Once more this formula overlaps with and carries over some of the properties of my daytime formula while still maintaining its effectiveness as a sleep formula. Among other things, wood nettle is an excellent tranquilizer. I am continuing to take 6 ml immediately before bed and additional 3 ml doses through the night, as required. However, in the last three weeks I haven't had to take an additional dose more than once or twice per week.

Homeopathic Remedies: I am continuing to take the same homeopathic remedies that I indicated in Part 3.

Supplements: I am continuing to take the same supplements that I indicated in  Part 2 except that I no longer need to take the probiotics.

Topical Herbal Preparations: It is with regard to the application of topical preparations that I have had to make a couple of adjustments, partly because of some unforeseen complications.

The first change to the protocols that I implemented was at the suggestion of Monika Ghent. She recommended that I use a scar formulation instead of a generic ointment on my incisions. Since Monika has a lot more experience than I do working with topical herbal preparations for healing and cosmetic uses, as this is one of her areas of specialization, I had her make up the formulation for me (see below). About two weeks ago I started using it on the scars from my incisions twice per day.

About a week and a half ago (7.5 weeks since my surgery) is when things got a bit complicated. Firstly, I started to get a rash on my leg around the area of my incisions. At first I wasn't sure what was causing it. Since I hadn't been using the scar ointment for very long and it contains a number of ingredients that I have never used before, I considered the possibility that I was allergic to one of the ingredients in that formulation. I stopped using it for a few days but the rash got worse. That's when I realized what was going on. I had over-astringed my leg from poulticing too much!

Pot marigold (Calendula officinalis) is a very potent healing and antimicrobial herb. It is also very astringent.
I increased the proportion of this herb to boost the antimicrobial element of my poultice formulation
which may have contributed to the more rapid astringing of my skin.

Contrary to what you are likely to read in the herbal literature, all herbs are astringent. This is because the most common astringent constituents, such as organic acids and polyphenols, are found in all plants. Whenever we apply herbs in concentration to a localized area there is a danger of astringing the tissues too deeply so that the affect penetrates down into the deeper living tissue layers. It is even more of a concern for mucus membranes, but it can happen to our skin as well. This is one of several reasons why it is very important that a poultice is very mucilaginous, because this reduces the affect somewhat. I had been applying a poultice to my leg for about 5 weeks at that point, twice per day for 30 minutes to an hour. I knew that the astringency would be a concern eventually. However, my poultices were very mucilaginous. I was applying oil-based preparations such as liniments and ointments to my leg twice per day as well. The moisturizing action of the oil also helps to counteract the affects of the astringency to some degree. In addition, because my fractures were healing well and also to reduce the potential for excessive astringency, in the last two weeks that I was applying poultices I only did the afternoon poultice a couple of times per week. So, I was taken off guard when I got the rash. I didn't expect it to happen that quickly given everything that I was doing. That being said, once I realized what was going on I stopped applying the poultices.

The second complication was that there were two spots, one at the top of each incision, where very thick scabs had formed. Scabs have an important protective function and are often an important element of the healing process. However, scabs can actually interfere with healing and lead to the formation of more scar tissue if they persist for too long. If they are relatively thick, they also interfere with the ability of the herbal constituents to penetrate to the underlying tissues where they are needed. Finally, by trapping too much moisture, they can also lead to infection. That's what happened in my case. I got a mild infection under the scabs. As a result, I stopped using the ointments on the scabs because the oil base can also contribute to trapping moisture under the scabs. Instead, I began applying essential oils directly to the scabs. I am using marjoram (Origanum majorana) because it is very antimicrobial. I combine it 50/50 with English lavender (Lavandula angustifolia) essential oil. Although the lavender is not as antimicrobial as the marjoram, it is a good combination because lavender essential oil is very healing and not as harsh. It is one of the few essential oils that can be used neat (undiluted). Combining them reduces the harshness of the marjoram essential oil. Essential oils are appropriate for this application because they are very penetrating and they don't contain any water or fixed oil (lipid), so they won't add to or trap moisture under the scab. I have been using them for a bit more than a week now and the infection is gone from one of the spots and almost gone from the other.

English lavender (Lavandula angustifolia) has been part of many of my systemic and local formulations.

Now that I've explained the complications I've had to deal with, here is what the topical protocols I am using currently look like:
  • When I wake up I apply the liniment I am using (see Part 2) to my whole lower leg up to and including my knee, but not to the area of the incisions themselves. I apply a 50/50 mixture of neat lavender and marjoram essential oils to the two areas where there was a bit of infection under the scabs. Then I apply Monika's scar ointment to the rest of the area of the incisions, and any remaining areas immediately adjacent where there is still a bit of the astringency rash to help heal and moisturize those tissues. Monika was kind enough to provide the ingredients of her scar formulation. It contains cocoa butter (Theobroma cacao), shea butter (Vitellaria paradoxa), castor oil (Ricinus communis), camellia oil (Camellia sinensis), argan oil (Argania spinosa), rosehip oil (Rosa rubiginosa), infused oil [St. Johnswort herb (Hypericum perforatum), pot marigold flower (Calendula officinalis), purple loosestrife herb (Lythrum salicaria), yarrow herb (Achillea millefolium) and American plantain herb (Plantago rugelii) in a base of olive oil (Olea europaea) and coconut oil (Cocos nucifera)], vitamin E (mixed tocopherols), vitamin D, English lavender (Lavandula angustifolia) essential oil, patchouli (Pogostemon cablin) essential oil, carrot (Daucus carota) essential oil, and Bach flower remedies [cherry plum (Prunus cerasifera), clematis (Clematis vitalba), impatiens (Impatiens glandulifera), rock rose (Helianthemum nummularium), star of Bethlehem (Ornithogalum umbellatum), crab apple (Malus sylvestris) and walnut (Juglans regia)].
  • In the evening before I go to bed I more or less repeat the morning protocol except that I use the comfrey ointment instead of the liniment.

On March 20, which was one day short of 7 weeks since my surgery, I had an appointment to have the first x-rays done since they were last taken immediately after my surgery. My leg felt strong and, as I suspected, the healing of my fractures looked very good. I also didn't have any pain when the surgeon put pressure on my leg from various angles. As a result, I was given the OK to begin carrying some weight with my leg. The original prognosis was that I wouldn't be able to do so for 12-16 weeks. So, this is in about half the time originally expected.

Fortunately I have been working hard to maintain as much strength and flexibility in my leg by doing various exercises and stretches. Stretching the tendons and ligaments, especially in my foot, ankle and knee, is actually the most difficult part of the rehabilitation process. At that time I had managed to get about 80% of the movement in my knee and 60-70% in my ankle. It has been steadily improving since.

During the first week I put about half of my weight on my leg when standing still (therefore 1/4 of my total body weight) and 10-20% of my weight on my leg while walking. I have also spent much more time walking around. For instance over the last 2 weeks I have been walking my dogs in the back field and woods where I live every day.

During the second week, which is ending today, I have been standing normally (therefore carrying 1/2 of my full body weight) and have worked up to carrying about 40-50% of weight while walking. I don't want to put too much stress on my bones too fast, so I will continue to increase the weight gradually and work towards being off the crutches in another 2-3 weeks.

As you can see, much of the scar looks like it is many months or even years old. The scabs near the top
of each incision are the areas that got infected. The dry areas from the astringency
of the poultices are slightly visible, especially below the lower incision.

Except for a couple of minor issues that I mentioned above, my fracture is healing very well. However, when I saw the surgeon a couple of weeks ago, there was some potentially bad news as well. There was a shadow in the x-ray at the bottom of my tibia below the lowest part of the plate that could be an indication of an infection in my bone. The surgeon wasn't completely sure, especially since there were no other indicators: no pain, no abscessing. He will reassess it when I see him in 2 weeks for another x-ray. In the mean time, I am focusing my treatment on my bone fractures and incisions. At this point I don't know to what degree I should be concerned about the possibility of infection. It is still inconclusive. So far all I've done is ramp up the essential oil content of my liniment when I apply it around my ankle by adding a couple of drops of marjoram essential oil to the liniment that I apply to that area. My current systemic formulation is going to run out in a couple of days and I will probably add an antimicrobial herb to the next version. I hope that it was just an anomaly in my x-ray because infections in bone are difficult to treat, even with a combination of herbs and antibiotics. If there is an infection, it would have been introduced during the surgery, possibly when the screws were put into my bone in that area. According to standard procedure, all of the materials they used would have been disinfected and I was given intravenous antibiotics during the remaining time (about 16 hours) that I was in the hospital following my surgery. Unfortunately, there is always a risk of acquiring an infection when in a hospital and the risks are greater when we must undergo surgery. Infections acquired in hospitals are often the multiple antibiotic resistant kind. In truth, I held out until the last minute on approving the surgery, partly for this reason. However, it was clear that my fracture was too severe and the likelihood of it healing properly with just a cast was very low.

If it turns out that there is an infection, this will require another aggressive protocol. I'll know in a couple of weeks. In the mean time, my fractures are healing amazingly well and I hope to be walking without crutches very soon. For this I am very grateful! I will continue the updates in Part 5.