A Crazy Season in the Life of an Herbalist!

Well, it's been a long time since I sat down at my computer and put any energy into this neglected child. Since April 2nd to be exact! I've contemplated it a few times, but the truth is that it has been such an incredibly busy seven months there hasn't been any time for it. Harvesting season begins in early to mid April, depending on how quickly things thaw, and ends some time in November or December when the ground freezes and I can't dig any more. This has always been a busy time for me. During the most intensive periods of harvesting, which are mid May to the end of July and late October to mid November, it is often necessary for me to devote the better part of three days per week to harvesting herbs and preparing tinctures - and that is on top of everything else that I need to do. There has always been a bit of travelling that was necessary during this time as well. Mostly to teach workshops but hopefully there is time for a holiday at some point. However, in the last few years my work has expanded into some new realms that require me to travel a lot more than I am used to. This year my travelling began on April 28th and ended on November 5th. During that time I was away three weeks in May, two weeks in July, one week in August, two weeks in September, two weeks in October, and the first bit of November. All of it was work related except for a week holiday in early September. We actually had to cancel a planned road trip to Nova Scotia in mid August because it would have been too much on top of everything else.

The interesting thing is that I'm not particularly into travelling, so it's surprising that my life has taken a turn of this nature. I'd rather just stay put and deepen my relationship with the land where I live from season to season, year to year. Nevertheless, the work that I am doing that requires me to travel is amazing and expansive, and I know in my heart that it is an important part of my path. It was a busy half year but it was all amazing. The challenge has been finding time to harvest all of the herbs that I need and fit in all of my clients on the few weeks that I am here. As it was, there were a few herbs that I wasn't able to get. In my world, that means that I have to use them less to stretch the stock that I have. When I eventually run out I won't have those herbs available until three months after I harvest them next year (three months is the minimum amount of time that I macerate tinctures).

It was a busy workshop season: Discussing black elder (Sambucus nigra) at an Herbal Field Studies workshop in early July.

This year things were even more challenging because of the weather that we had. After a record breaking, bitter cold winter and late thaw, we had a very strange spring and summer. It was much cooler than normal but not in the usual way. We do typically get a cool summer about once per decade. But those summers are usually very cloudy and wet, with very little sunshine. This year it was cloudy and wet a lot of the time, but we didn't get the days (sometimes weeks) of constant rain that we usually get during this kind of summer. On the rainy days the rain was more intermittent. We also had very few thunder storms. On the positive side, most weeks we still got at least a few sunny days. This was very important from an herbalists perspective because during years when it is almost constantly cloudy and rainy, although herbs that like that kind of weather such as stinging nettle (Urtica dioica) and coltsfoot (Tussilago farfara) do very well, herbs that don't like it such as red clover (Trifolium pratense) and common St. Johnswort (Hypericum perforatum) do very poorly. For many herbs in the latter category it just isn't worth harvesting them as the quality of their medicine is very low. Fortunately, many plants can tolerate a range of habitats that get different amounts of sunlight. Therefore, it is possible to partially compensate for unusual weather conditions by harvesting them in different locations. During hot, dry years it is often possible to find healthy populations in the part of their range where they get less direct sunlight. In these areas they will experience less heat stress and the soil will be more moist. In cooler, wetter years we harvest them in the part of their range where they get the most sunlight. Here they will get as much sun as possible and the soil will be less wet. However, during extreme years even this doesn't work for some herbs and I have to pass on harvesting them and make up for it by using more of some of the other herbs that can be used as a substitute in various contexts. This is one of the reasons why it is necessary to work with a rich and diverse group of herbs. I also usually try to harvest enough herb to make a two year supply of tincture for herbs that this is manageable, meaning the ones that I use in small to moderate quantities. This is partly so that I don't have to harvest every herb every year, but also to build some resilience into my supply of tinctures. If for some reason I am not able to get some of the herbs that I need in a particular year, there will be more choices if I have to use substitutes.

Common St. Johnswort (Hypericum perforatum) doesn't like cool, cloudy, wet years.

In our area, from mid June to mid September we can usually count on at least a few weeks of hot, humid weather with temperatures of 30+ °C (86+ °F). This year we only got a couple of days of temperatures in the 30s in June and then another couple in July. As a result, although plants that like a fair bit of sun, such as wild mint (Mentha arvensis) and wild bergamot (Monarda fistulosa), and flower earlier in the season did fairly well with the amount of sun that we had in spite of lots of rain and cooler temperatures, some of the plants that need more heat and flower later, such as peppermint (Mentha x piperita) and spearmint (Mentha spicata), really suffered from the cumulative affects of the weather. In our area they didn't flower until early September and the quality was too poor to harvest.

Wild mint (Mentha arvensis) got enough sun and produced some good medicine this year.

Another thing that stood out this summer was the continuing decline of the local honey bee (Apis mellifera) population. Around my home there are many species of clover. They all came into flower in June: first red clover; then alsike clover (T. hybridum); then white clover (T. repens); then yellow sweet clover (Melilotus officinalis); then white sweet clover (M. alba). Honey bees love many flowers, but the clovers are among their favorites. Yet, during their peak flowering in June and July I didn't see a single honey bee. A few years ago these flowers were covered in them! There is a wild hive in the woods about 400 m from my house. This year it didn't become active until early July. As their numbers increased they gradually expanded their range, but I didn't see any within 100 m of my house until the Canada goldenrod (Solidago canadensis) was well into flower in mid July. Recent evidence suggests that a major factor in the collapse of the honey bee population in much of North America is the use of a group of pesticides that are nicotine derivatives called neonicotinoids. It's typical for us to look for simple, unidimensional solutions, but as with everything in life the cause is a lot more complicated than that and due to a combination of factors. In all likelihood the bees are being killed or weakened by the combined effects of neonicotinoids and other pesticides and, as a result, the weakened individuals are also becoming less resistant to various parasites. There are probably other environmental factors involved as well, but something needs to be done about it quickly and reducing the use of neonicotinoids is a good place to start.

The population of this colony of honey bees living in a crack in an old white pine (Pinus strobus) near my home

has been significantly reduced in the last few years

Needless to say, between the travelling and the weather conditions it was very difficult for me to get all of my harvesting done this year. There were a few plants I didn't have time to harvest and a few more that weren't good enough to harvest. This has continued up to the present. Unlike the spring and summer, September and October were warmer than usual. This had it's own challenges. For instance, I had to be away from October 24th to November 5th. I needed to harvest maidenhair tree leaves (Ginkgo biloba) before I left. I have found that the best time to harvest the leaves is in the fall when they are about midway between their transition from green to gold. In the region where I live this is usually around the third week of October. However, because of the warm weather, when I went to harvest them on October 21st they were only just beginning to turn. I knew I couldn't wait until I came back because by then they would have fallen, so I harvested them that day. They weren't perfect but they were good enough.

The maidenhair tree leaves (Ginkgo biloba) started turning gold late this year because of the warm fall.

Note the contrasting yellow and orange of the sugar maple trees (Acer saccharum) in the background.

When we returned from Mexico on November 5th the warm weather was still with us. Right away I had to get to work because the aerial parts of most of the herbaceous plants had already died back and it was time to start harvesting roots and rhizomes. We need to get them done before the ground freezes and we can't dig any more. There are also a few fruits that I need to harvest at this time of year, but they have to be harvested after a couple of good frosts, so they weren't ready yet. Things started out OK. We were getting highs of around 8-12 °C (46-54 °F) and lows of 4-7 °C (39-45 °F) and not too much rain. Perfect root harvesting weather! We got to work right away.

Here's Monika harvesting stinging nettle rhizome (Urtica dioica).

Then on November 11th the temperature went up to 18 °C (64 °F) and the next day it dropped below freezing! For a few days it wasn't so bad because the the daytime temperatures were staying above freezing. But by the end of the week temperatures had dropped to January levels. I still needed to harvest several herbs and was worried that the ground might freeze before I could do them all. The unseasonably cold temperatures weren't just a stress for us. Everybody was feeling it! On Sunday morning in my peripheral vision I caught a movement outside my kitchen window. I knew it wasn't a bird that should still be hanging around here at this time of year and sure enough there was a yellow-rumped warbler (Setophaga coronata) shivering in a tree just outside the window. That was November 16th. I have never seen any species of warbler around here later than mid October. He was probably migrating through from somewhere much further north. With the lingering warm weather he must have been taking his time. That choice could turn out to be fatal!

This is a yellow-rumped warbler (Setophaga coronata), but not the yellow-rumped warbler.

As if the cold temperatures weren't enough of a challenge, last Sunday night and all day Monday it snowed. Fortunately, we didn't get that much. I can't imagine what it must have been like a little south of us in Buffalo, New York where they got completely buried! That would have definitely been the end of the harvesting season for us.

It was incredibly beautiful in the woods on Monday afternoon. The first snow. It was perfectly still and silent, and everything was covered in a blanket of white. Monika and I would have preferred to have just gone for a nice walk. But, still racing against winter, instead we went out and harvested wild sarsaparilla rhizome (Aralia nudicaulis). This herb is a colonial species with a network of rhizomes that does not leave a recognizable stalk standing after it dies back. Below the snow and fallen leaves, the only way to identify it is by the crowns with the buds of next years growth that usually sit a bit higher than the surface of the soil. Finding them is easy, but only if you know exactly where they are growing! It's simply a matter of clearing away the snow and leaves, finding the buds, and following the rhizome from that point.

Harvesting wild sarsaparilla rhizome (Aralia nudicaulis) last weekend. Note the bud in the centre foreground.

Since Monday it has been even colder. The ground is starting to freeze, but fortunately hasn't yet completely because we got just enough snow to insulate the ground a bit. Yesterday I was able to get out and harvest high bush cranberry fruit (Viburnum opulus), which are ready now that the temperature has gone below freezing. There are a few good sized colonies of these shrubs on the property where I live. But for some reason none of them produced fruit this year. They all flowered. I can only assume that there was something about the conditions when they flowered that affected their ability to produce fruit. As a result, I had to hike a couple of kilometers into the back fields in order to find an area where there was a good supply of fruit.

High bush cranberry fruit (Viburnum opulus) can't be chopped on a cutting board because they are too juicy.

They need to be ground for a few seconds with a bit of menstruum. Great colour!

Starting today the temperature is going up again and we are supposed to get rain with the temperature peaking at around 13 °C (55 °F) by Monday before it starts dropping again. That will melt the snow and warm up the soil a bit and it looks like I will be able to harvest the last two herbs that I need to get: marshmallow root (Althaea officinalis) and wild ginger rhizome (Asarum canadense). After that harvesting season will be over for this year and I'll be using the time that I have been devoting to harvesting to converting classroom courses to online courses. This is something I don't have much time for during harvesting season. I'll also have more time to put up some more stuff on this blog. It won't be another six months until the next one!

Until next spring I can spend more of my time in nature just being with a lot less doing. I'm looking forward to that. I'm also putting out some good energy for my little winged friend and others like him that lingered too long. I hope they are able to make it to the warmer regions down south!

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!

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)!

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.

Applying a Poultice

This post is an tangent from my series on Healing Bone Fractures. In that series I have mentioned applying herbal poultices to my leg. I had considered including more details about applying a poultice in one of those posts but decided to do it separately so I can provide more details. I would like to thank my friend Elyse Portal who took some great photos while I was applying a poultice to my leg last weekend.

For the most part, a poultice is the most potent method of application of herbs to a localized area. This is because as the constituents of the herbs are absorbed into our tissues through the layer of moisture covering our skin, they are immediately replaced by more constituents from the herbs that diffuse into the layer of water. Also, the concentration of constituents is very high because the ratio of herb to liquid is very high. We are using a lot of herb and very little water.

We usually use dried herbs, but I often apply what I call a "survival poultice" if I get some kind of injury or bite when I'm wandering around in the fields and woods. In these circumstances I will find one or a few good healing herbs in my immediate area, chew them up and apply them where needed. I used to do this for my kids when they were small and we were on a hike or camping trip. You don't need to worry too much about bacteria in saliva because the antimicrobial properties of the herbs are very concentrated when applied this way and will take care of any risk of infection.

Here is the bowl of dried herbs I'm using for this particular poultice.

When using dried herbs, they should be coarsely ground. I usually rub them between my palms or use a mortar and pestle. We apply just enough boiled water to moisten them but so that they are not runny.

The herbs after moistening them with boiled water.

The purpose of the poultice I am preparing is to help heal the incisions from my surgery and to penetrate deeper into my leg to help heal my broken tibia (shinbone) as well. This poultice consists of 1 part common comfrey leaf (Symphytum officinale), 1 part stinging nettle leaf (Urtica dioica), 1 part purple loosestrife herb (Lythrum salicaria), 1 part pot marigold petals (Calendula officinalis), 1 part Canada goldenrod herb (Solidago canadensis) and 1/2 part whole flax seed (Linum usitatissimum). It is essential that a poultice is very mucilaginous. Comfrey is one of the few herbs that is mucilaginous enough that it doesn't require the addition of a more mucilaginous herb. However, since comfrey is only making up 20% of this formulation, it is necessary to add something to make it more slimy. My preference is to use a small amount of whole flax seed whenever I prepare a poultice. It will add the extra mucilage that we need and has important healing properties of its own. Never use ground flax seed. We just want the mucilage. We don't want to release the oil.

Getting ready to apply the poultice. At this point I had been poulticing the smaller incision on the right twice per day

for two weeks and the larger incision on the left for one week. There is clearly a difference between the two.

When applying a poultice I always put some gauze between the poultice and the skin. This serves two purposes: firstly, it ensures that small particles of herbs can't get into an open wound; secondly, it allows the poultice to be easily lifted off when finished without having to wipe bits of herb off the skin. This is important because when we remove the poultice we want any remaining herb infused liquid to dry on the skin. We use the minimum amount of layers of gauze to prevent bits of herb from getting through. The number of layers will depend on the thickness of the gauze.

Laying the gauze in preparation for the poultice.

When we apply the poultice we must completely cover an area a bit larger than the area we are working on with the moistened herbs and press down on them so that there is good contact with the skin. I usually apply it with a spoon and use the spoon to press the herbs once they are applied.

Beginning to apply the poultice...

...and finishing it off.

Under normal circumstances our skin is water-proof. In order to get the constituents of the herbs in our poultice to penetrate through our skin our skin must be hydrated to eliminate its water-proof characteristics. To accomplish this it is necessary for the entire area where we wish to apply the poultice to remain moist. We can't allow the skin to breathe. To accelerate this process it is also necessary that the poultice be applied as hot as we can tolerate and remain warm for the duration of the application. This process also takes time. The longer the poultice is in contact with our skin, the more hydrated our skin becomes and the better the penetration. I usually recommend a minimum of 30 minutes, but an hour or more is sometimes necessary, depending on the severity of the condition being treated. To facilitate the hydration of our skin it is best to wrap the poultice in plastic so that our skin remains in complete contact with herb infused liquid from our poultice and isn't able to breathe (no contact with air). Most types of plastic wrap are made of polyethylene which isn't known to leach any toxic chemicals. After wrapping the poultice I recommend pushing down on it once more to make sure there is good contact with the skin and no air spaces between the plastic and the herbs.

The poultice wrapped in plastic.

This whole process must be done as quickly as possible so that the herbs are still hot. Once the poultice has been wrapped in plastic it is necessary to cover it with a towel or something similar to help insulate it to keep it warm. If is going to be applied for a long period of time it may be necessary to apply a hot compress over the plastic. A cloth soaked in hot water that has been wrung out so that it isn't dripping will do. The cloth can be reheated periodically when it cools down. If the area where we need to apply the poultice isn't too large, a hot water bottle will also work and is more convenient than using a compress.

Covering the poultice with a couple of layers of towel.

Once we are done we can remove the poultice. For my leg, I have been applying a poultice for 45-60 minutes twice per day. When we use gauze the whole thing will lift off really easy.

The poultice has been uncovered and is ready to be removed.

When we remove the poultice the skin will be moist with herb infused liquid. We don't want to wipe this off. Let it dry completely before covering the area.

After removing the poultice we let the remaining liquid completely dry on the skin.

Notice the larger droplets of herb infused water.

Once the remaining herb infused water has dried completely the process is complete. We can bandage the area, if necessary, or cover it in some other way. We can also apply an ointment or liniment to the area, if appropriate, to further assist the healing process.

Which herbs we use, how often and how long we apply a poultice will depend on the situation, but the basic elements of applying a poultice will always be the same.

Healing Bone Fractures, Part 3 of 5

This is the third 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 this post I am providing an update on how things are progressing four weeks after my surgery and any modifications that I have made to the protocols that I am using.

Systemic Herbal Formulation: On the fifth day after my surgery I was finally able to make a specific herbal formulation to treat my injury. I made up a 250 bottle, which lasts two weeks at the dose I am taking (for the details see Part 2). This formula ran out during the third week after my surgery. Although I was only taking it for two weeks and I could have just repeated the same formula, I decided to make a slight change to the formula. Since there is no evidence of nerve damage, I eliminated the St. Johnswort (Hypericum perforatum). I also substituted stinging nettle (Urtica dioica) for common horsetail (Equisetum arvense). The second version of the formulation contains turmeric rhizome (Curcuma longa) 18%, stinging nettle herb (Urtica dioica) 20%, boneset herb (Eupatorium perfoliatum) 20%, American plantain herb (Plantago rugelii) 20%, common comfrey herb (Symphytum officinale) 15%, wild ginger rhizome (Asarum canadense) 5%, 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.

St. Johnswort (Hypericum perforatum), topically, systemically and in homeopathic potencies,

is a very important herb for healing nerve damage.

Herbal Sleep Formulation: Due to the changes to my primary systemic formulation 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) 15%, St. Johnswort herb (Hypericum perforatum) 15%, catnip herb (Nepeta cataria) 15%, American plantain herb (Plantago rugelii) 15%, hop strobilus (Humulus lupulus) 15%, stinging nettle herb (Urtica dioica) 15%, 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. Just as with plantain, it is rare for stinging nettle herb to be acknowledged as a sedative in the herbal literature. In fact, it is a very calming herb, especially when harvested a bit later in its life cycle when a some of the harvested portion includes the immature seeds. These are the most sedating part of the plant. I am continuing to take 6 ml immediately before bed and additional 3 ml doses through the night, as required.

More On Sleep: For reasons that I explained in Part 2, getting sufficient sleep has been a real challenge for me, even with the herbal sleep formula. By day 23 after my surgery I still had experienced only a slight improvement in my sleep, so I decided to go one step further and take melatonin as well. In the past I have found that clients with moderate to severe insomnia for whom an herbal sleep formula does not produce sufficient results usually respond well to the addition of a small amount of melatonin into the mix. Although I am not experiencing typical insomnia, my hope was that this will help me to sleep deeper and I won't wake up as much due to the discomfort and stiffness I have been experiencing as a result of having to lie on my back all night. I have to say, I was appalled at the poor selection of melatonin products even in a very well stocked health food store. Most of them had additional undesirable ingredients such as high doses of individual B vitamins or calcium. In addition, the doses of melatonin were way too high. Melatonin is a hormone and, although it is safe when used correctly, it is important to use only the minimum dose that will produce the desired results. The way I recommend people take it is to begin with a 0.5 mg dose for a few days. If that isn't strong enough I have them increase the dose in 0.5 mg increments (allowing a few days each time the dose is increased to determine its effectiveness) until they hit the ideal dose for them. One of the advantages of using melatonin in combination with a good herbal sedative is that they are mutually synergistic and, when taken concurrently with the herbs, the melatonin will usually produced the desired result at a very low dose. Although I did find a few products that had relatively low (1 mg) dose of melatonin, they all had other things in them that I didn't want to take. As a result, I ended up purchasing a 3 mg sublingual lozenge that I am able to cut into quarters so that each dose is approximately 0.75 mg. I take 0.75 mg of melatonin about 15 minutes before I go to bed and then take a 6 ml dose of my sleep formulation just before bed. When I wake up in the night and have difficulty falling back to sleep, if it seems that I won't have too much difficulty falling asleep I will take an additional 3 ml dose of the tincture. However, if it seems that I am going to have more difficulty, I will allow myself one more 0.75 mg dose of melatonin in addition to 3 ml of the tincture. If I wake up additional times through the night and have difficulty falling asleep I will only take the tincture. As it turns out, the first night I required two doses of melatonin but after that my sleep improved so much I only required one. I have found that I am waking up less often through the night and having less difficulty falling back to sleep when I wake up.

Homeopathics: On day 23 after my surgery, when I added the melatonin, I also diverged from the homeopathic protocols that I had intended to follow (as indicated in Part 2). I am continuing to take Symphytum 200C three times per day to support the healing of my bone. Since I was past the stage of the initial tissue trauma, I dropped the Arnica. As there seemed to be no major nerve damage, but there is a little bit of numbness of my skin along the major incision, I dropped the Hypericum 200C to one dose per day. To address the mild numbness I also kept Hypericum (St. Johnswort) in my sleep formulation even though I eliminated it from my daytime formulation. I also added Rhus 200C two doses per day. Rhus is for injuries or strains that stiffen up and feel worse when they are rested for periods of time, but feel better when we move around. These symptoms are typical for me whenever I have injuries or stiffness. I always feel better when I can move around and limber up. My hope was that the Rhus will help reduce the stiffness I am experiencing from lying on my back all night, since this stiffness is one of the things interfering with my sleep. It has helped somewhat and I have experienced a significant improvement in my sleep since adding the Rhus and melatonin to my protocols. It is my intention to continue taking these three homeopathic remedies in these doses for the next few weeks.

Eastern poison oak (Toxicodendron pubescens) was formerly classified as Rhus toxicodendron.

The names of homeopathic remedies are often based on obsolete botanical names

so as to maintain the continuity of the name with older homeopathic texts.

Topical Herbal Preparations: I have two incisions in my leg. A smaller one just below my knee and a larger one that runs down to my ankle which is the area where the plate was put in. On day 13 after my surgery all of the stitches in the smaller incision were removed, but the surgeon decided to remove only half of the stitches in my larger incision because the inflammation and edema were putting a lot of pressure on that area. He wanted me to come back in two more weeks to have the remainder of the stitches removed. On day 16 we began applying a poultice to the smaller incision from which all of the stitches had been removed (for more details about the poultice, see Part 2). We decided to use it as an opportunity to demonstrate how to apply a poultice during our Making Herbal Tinctures workshop. By day 18 it was apparent that the healing of the smaller incision was already much further along than the larger incision to which I was not yet able to apply a poultice because of the remaining stitches. I tried to get an appointment that week to see the surgeon and have the remaining stitches removed so that I could begin working on the longer incision, but there were no appointments available. As a result, I decided it was best if I removed the stitches before my appointment the following week. On day 23, herbalist (and my partner) Monika Ghent removed them for me in the morning. We allowed the holes to seal during the next few hours and began applying a poultice to the larger incision as well that night.

This photograph was taken of my leg just before we removed the remaining stitches from the larger incision.

Notice how much further along the healing is on the smaller incision which at this point I had been

poulticing for a week. The redness is in areas that were formerly covered by scabs.

Since then the protocol that I have been using is as follows:

• 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 an ointment to the incisions. The ointment is made from the same infused oil that I used as the base for my liniment (see Part 2) with a little bit of English lavender (Lavandula angustifolia) essential oil added to it (probably about 2 drops in each 25 ml jar). Both the infused oil and the ointment were made during our Herbal Field Studies field workshops.
• In the mid afternoon I apply a poultice to both incisions (for details see Part 2). I leave them on for 30-45 minutes and then remove them and allow the plant juices to dry on my leg. I do not apply anything else at that time.
• In the evening I apply a second poultice to both incisions. However, after I remove them and the plant juices dry on my leg I apply a comfrey (Symphytum officinale) ointment to my whole lower leg below the knee including the incisions. I had not prepared any comfrey ointment but fortunately my friend and fellow herbalist Rick DeSylva provided me with an jar of his excellent comfrey ointment.

This is what the protocols I am using look like at about 4 weeks after my surgery. There is no pain in my leg even when I touch the area where the incisions and fractures are. The surgeon was quite surprised at that. My leg feels strong and I am doing my best to stretch the tendons and ligaments in my ankle and knee so they don't tighten up too much while I'm not walking. There is some edema in my foot because I am spending a fair bit of time upright, which allows the blood and lymph to pool in my foot. This is has gone down somewhat but is still significant except when I wake up in the morning after I've been horizontal through the night. It is something I'm going to have to put up with until I start walking unless I want to spend the whole day sitting or lying with my leg raised, which is not an option.

I will continue provide updates on how things are progressing and any changes to my protocols in Part 4.