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.

Healing Bone Fractures, Part 2 of 5

This is the second 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 this post I am going to explain the protocol that I implemented when I returned home.

I returned home on evening of Sunday February 3rd, four days after my injury and three days after my surgery. On Monday we picked up some additional supplements that I needed and then on Tuesday I made up a couple of new formulations specifically formulated to address my injury. This is the protocol that I implemented at that time:

Homeopathics: I am taking Arnica 200C, Hypericum 200C and Symphytum 200C individually, four pellets per dose alternated throughout the day. The dosage of each remedy varies over time according to the following protocol:

• Week 1: Arnica 4 doses per day; Hypericum 4 doses per day; Symphytum 4 doses per day.
• Week 2: Arnica 3 doses per day; Hypericum 3 doses per day; Symphytum 3 doses per day.
• Week 3: Arnica 2 doses per day; Hypericum 2 doses per day; Symphytum 3 doses per day.
• Week 4: Arnica 1 dose per day; Hypericum 1 dose per day; Symphytum 3 doses per day.
• Week 5 and onwards (until my bones are completely healed): Symphytum 3 doses per day.

Herbs: I created three new formulations to address my specific needs:

• A systemic herbal formulation prepared from 1:5 fresh herb tinctures containing turmeric rhizome (Curcuma longa) 18%, common horsetail herb (Equisetum arvense) 15%, boneset herb (Eupatorium perfoliatum) 15%, St. Johnswort herb (Hypericum perforatum) 15%, American plantain herb (Plantago rugelii) 15%, common comfrey herb (Symphytum officinale) 15%, wild ginger rhizome (Asarum canadense) 5%, white pine leaf/twig (Pinus strobus) 2%. This formulation is a specific for healing damaged tissues and blood vessels, bone, and improving general circulation. Boneset and turmeric also have a significant tonic action on the liver which will help address any stress on my liver from the medications and other aspects of my hospital experience, as well as protect my liver from any toxicity from the pyrrolizidine alkaloids in the comfrey, which is the best herb I know for healing bones and well worth the very slight risk of toxicity. Given that the comfrey will not exceed the 15-20% range in any of the formulations that I use and will be combined with herbs that can mitigate its potential toxicity, the likelihood of any toxicity is almost nil. Boneset and horsetail are also specifics for healing bone tissue. This formulation is taken in 6 ml doses three times per day on an empty stomach, 5-10 minutes before each meal.

Boneset (Eupatorium perfoliatum) is an excellent healing herb that is very effective for the healing of bone tissue.

• A systemic herbal sleep formulation prepared from 1:5 fresh herb tinctures containing English lavender flowering spike (Lavandula angustifolia) 20%, St. Johnswort herb (Hypericum perforatum) 20%, catnip herb (Nepeta cataria) 20%, American plantain herb (Plantago rugelii) 15%, hop strobilus (Humulus lupulus) 15%, turmeric rhizome (Curcuma longa) 9%, white pine leaf/twig (Pinus strobus) 1%. The dosage of this formulation is 6 ml immediately before bed and additional 3 ml doses through the night, as required. Getting sufficient sleep is one of my greatest challenges. I tend to be a light sleeper. I sleep on my sides and wake up four or five times a night feeling a bit stiff and change my position, flipping from side to side and then falling back to sleep fairly quickly. With my broken leg I can only sleep on my back. This is difficult for me because as a general rule I can't sleep on my back, and it also doesn't allow me to shift my position sufficiently. By half way through the night my lower back is very stiff and sore. Most nights I'm only getting five to six hours sleep, and that's with the sleep formulation. Occasionally I get a bit more. Getting sufficient sleep is critical to the healing process, so I made this formulation to help me sleep better. Notice that it contains a few of the herbs that are in my daytime formulation. This is to help continue to support the healing process through the night. It is also important that the overlapping herbs contribute to the sleep formulation. You will find few, if any, references to plantain having sedative properties, but it does. As a general rule, whenever someone is taking more than one herbal formulation concurrently, it is usually preferable if there is some overlap between the herbs in the different formulations. As in this case, the overlapping herbs must contribute to the desired actions of both formulations.
• A topical liniment made up of a base containing 1:5 fresh herb infused oils of pot marigold flower head (Calendula officinalis), Canada goldenrod leaf (Solidago canadensis), wild bergamot herb (Monarda fistulosa), coltsfoot leaf (Tussilago farfara), St. Johnswort herb (Hypericum perforatum), northern white pine leaf (Pinus strobus) and American plantain herb (Plantago rugelii). This infuse oil was prepared last year. The herbs are in descending order based on proportion as I am not certain of the exact percentages. To the base oil I added the following essential oils at an overall potency of two drops per ml of base oil: rosemary leaf (Rosmarinus officinalis) 25%, English lavender flower (Lavandula angustifolia) 25%, black spruce leaf/twig (Picea mariana) 15%, marjoram herb (Origanum majorana) 10%, eastern hemlock leaf/twig (Tsuga canadensis) 10%, Roman chamomile flower head (Chamaemelum nobile) 5%, yarrow herb (Achillea millefolium) 5% and eastern white cedar (Thuja occidentalis) 5%. I apply this twice a day, immediately upon waking and just before bed, to the lower thigh, knee and half of the foot of my injured leg as my leg below my knee and half of my foot are covered by a tensor bandage. I also apply it to the hip, knee and ankle of my left leg, and my wrists, as these areas are being stressed in unusual ways due to using crutches.

In this photograph we have common plantain (Plantago major), an alien species that has naturalized throughout

North America, on the left, and American plantain (P. rugelii), our native species, on the right. Notice the

reddish colour at the base of the petioles (leaf stalks) of American plantain. Most people

(including herbalists) don't realize that these are two different species.

Two weeks after my surgery I went to the hospital to have my stitches removed. There was a lot of pressure on my stitches due to the edema in my leg that occurs whenever I am moving around in an upright position. The blood and lymph tends to pool in my leg because I am not using my leg to walk, which is necessary to efficiently pump the fluids out of my leg against the force of gravity. As a result, the doctor decided to leave every second stitch in my lower, longer incision for another two weeks. In the mean time, beginning a couple of days after I got my stitches out I started poulticing the shorter incision from which all of the stitches were removed. I am applying a poultice twice per day for 30-45 minutes. The primary herbs that I am using are common comfrey leaf (Symphytum officinale), stinging nettle leaf (Urtica dioica), pot marigold petals (Calendula officinalis), purple loosestrife herb (Lythrum salicaria), and a bit of whole flax seed (Linum usitatissimum) to increase the mucilage content. I use these herbs in roughly equal proportions (except for the flax seed) and each time add a sixth herb in a similar proportion. I have a lot of "ends" which are small quantities of herbs that are left over from when I harvest herbs to make tinctures. I dry these remainders and use them when the opportunity arises. This is one of those opportunities. Each time I make a poultice I use a different sixth herb. Some of the herbs that I have used so far include elecampane leaf (Inula helenium), wood nettle leaf (Laportea canadensis), Canada goldenrod herb (Solidago canadensis), blueweed herb (Echium vulgare), blue vervain herb (Verbena hastata), wormwood herb (Artemisia absinthium), yarrow herb (Achillea millefolium), yellow bedstraw herb (Galium verum) and pearly everlasting herb (Anaphalis margaritacea).

Supplements: I was able to obtain the additional supplements that I need over the course of the first week that I was back so that since about a week and a half after my injury I have been on the full complement of supplements that I need to help heal my leg. These supplements are very important whenever there is significant tissue damage, but they are particularly important for healing damaged bone, cartilage, tendons and ligaments, regardless of the cause of damage. I use a similar supplement regimen for the treatment of osteoarthritis and osteoporosis. Although there are a number of supplements available that are formulated for building bone tissue that contain some of these nutrients, I chose not to use any of them because I didn't like any of the formulations. All of them were missing important nutrients, had way too much calcium relative to the other ingredients, and most of them were compromised in some way by using cheaper, low quality ingredients such as magnesium oxide. As a result, I had to put this supplement regimen together using a fair number of products. Nevertheless, the importance of using all of these nutrients in the right balance can not be over emphasized. I have listed them here by nutrient instead of by which ones I am taking with each meal, as I did in the first post of this series, so that it is more clear what I am taking. All of these are taken with meals:

• Vitamin A: 3,500 IU with breakfast; 3,500 IU with dinner.
• Beta-carotene: 750 IU with breakfast; 750 IU with dinner.
• Vitamin C (calcium and magnesium ascorbate): 1,485 mg with breakfast; 1,360 mg with lunch; 1,485 mg with dinner.
• Vitamin D: 1,200 IU with breakfast; 1,000 IU with lunch; 1,400 IU with dinner.
• Vitamin E (mixed tocopherols, acetate): 115 IU with breakfast; 40 IU with lunch; 315 IU with dinner.
• Vitamin K: 60 mcg with breakfast; 80 mcg with dinner.
• Calcium (citrate, ascorbate, malate): 150 mg with breakfast; 135 mg with lunch; 450 mg with dinner.
• Magnesium (citrate, ascorbate, malate): 60 mg with breakfast; 60 mg with lunch; 260 mg with dinner.
• Zinc (citrate): 5 mg with breakfast; 25 mg with dinner.
• Silicon (aqueous horsetail extract): 4.7 mg with breakfast; 4.7 mg with lunch; 4.7 mg with dinner.
• Manganese (chelate, citrate): 0.5 mg with breakfast; 5.5 mg with dinner.
• Copper (citrate): 0.5 mg with breakfast; 1.5 mg with dinner.
• Boron (chelate): 350 mcg with breakfast; 350 mcg with dinner.
• Selenium (chelate): 50 mcg with breakfast; 150 mcg with dinner.
• Polyphenol complexes (flavonoids, anthocyanidins, proanthocyanidins and catechins from extracts of berries, citrus, grape seed and green tea): 325 mg with breakfast; 225 mg with lunch; 325 mg with dinner.
• Quercetin: 100 mg with breakfast; 100 mg with lunch; 100 mg with dinner.
• Lutein: 0.5 mg with breakfast; 0.5 mg with dinner.

Blueberries (Vaccinium spp.) are a very rich source of anthocyanins and flavonoids, including quercetin.

Some of these are ingredients from a multivitamin that I am taking with breakfast and dinner. It is a good quality low potency multi with an excellent trace mineral content. It does not contain iron. I did not list all of the ingredients of the multivitamin, only those that are important for bone repair. However, the full range of nutrients in the multi are important to support healing in general. Mostly what I haven't listed are the B vitamins and some of the other trace minerals. In addition, I am also taking omega-3 fatty acids in the form of organic flax seed oil, 2-3 teaspoons taken throughout the day mixed in food (but not heated).

In addition to the above supplements that I am taking with meals, I am also taking the following on an empty stomach three times per day 30 minutes before each meal:

• Methylsulfonylmethane (MSM) 400 mg.
• Glucosamine hydrochloride 300 mg.
• Betaine 80 mg.
• Hyaluronic acid 10 mg.

Probiotics: Another one of the challenges that I am dealing with is constipation. It started with fasting from food and water for 16 hours before my surgery and was further aggravated by the intravenous hydromorphone and three courses of intravenous antibiotics that I was given through the night after my surgery. However, the ongoing issue is that I am spending a lot more time sitting and can't walk or run, which is important for good bowel tone. I am addressing this by taking a high potency probiotic supplement that contains 25 billion active cells of a combination of eight active strains of bacteria. I take this first thing in the morning in a glass of warm water with a tablespoon of whole organic flax seed. My bowel movements gradually returned to normal during the first week that I took this and I am continuing to take it on an ongoing basis.

Lactobacillus rhamnosus: An important probiotic species.

Exercise: This is another of my major challenges. The surgeon wants me to spend most of my day sitting or laying with my injured leg raised. This is not an option. It's bad enough that the muscles in my right leg are getting weaker. I'm not going to sit around and let my whole body atrophy. Plus, I have clients and students that depend on me and lots of work to be done. My life has definitely slowed down and there are many things that are too difficult or impossible for me to do, but I'm not out of commission completely. I have sit stations all over my house where I work, eat and rest consisting of a padded chair to sit on and a second chair with a pillow on it that I can put my leg up on. I have found that there is a delicate balance between sitting and moving around upright. If I do either for too long, the edema in my lower right leg gets worse.

Aside from the exercise I get moving around on crutches, every morning before breakfast I do an upper body workout with light weights and lots of stretching. I'm also working my injured leg as best I can. Whenever I'm sitting for periods of time I periodically massage my thigh and knee. I also wiggle my toes a lot and gently stretch the tendons and ligaments in my ankle and knee. In addition, I'm doing my best to work out my right knee and hip as best I can without being able to walk. To maintain some level of strength in these joints I do leg lifts from my hip raising my whole leg, and from my knee raising my lower leg several times per day for a few minutes. I also "pump" my leg while I'm walking on crutches by raising my leg and bending my knee on one step and then lowering my leg on alternate steps. As before I also continue to do deep breathing exercises in which I "feel" the life force or qi energy flowing into and out of my leg.

Diet: My diet is pretty good in general. It is almost completely organic and I get a lot of variety. My only concern is getting a bit more good quality protein. I have been a vegetarian for 33 years. Contrary to what some people believe, it is very easy for vegetarians to consume sufficient protein. Nevertheless, a good supply of high quality protein is necessary to heal bone tissue. Rather than bump up some of the typical high protein vegetarian foods such as beans or nuts which are harder on the digestive system, I have decided to increase my protein somewhat by eating one or two organic, free-range eggs most days. I have to strike a balance here and not eat too many eggs because for me eggs tend to be constipating.

So there you have it! This is the regimen I am following at this time. It is very intensive. I probably spend about 10% of my waking hours engaged in some aspect of this healing protocol. However, that's not bad considering I am still working at about 60% capacity instead of laying around like the surgeon advised me to. Also, with the exception of the intravenous hydromorphone and three courses of intravenous antibiotics that I was given through the night immediately after my surgery, I did not fill the prescription for painkillers that the surgeon gave me and only had to take a single dose of acetaminophen about 24 hours after my surgery. When I had the stitches removed, the surgeon prescribed another course of antibiotics and some anti-inflammatories. I didn't fill those prescriptions either. My intent is not only to stay relatively functional through this process, but also to make sure that my bones heal well and are strong enough to allow me to continue doing what I've always done. I'm also hoping to be able to start putting some weight on my leg a fair bit earlier than the three to four months that the surgeon predicted.

Overall, I have to say that the biggest challenge for me has been not being able to walk the land. In my normal life, every day I take my dogs out for about an hour and a half and walk the trails through the fields and forest where I live. Aside from the obvious benefits of the exercise and fresh air for the dogs and myself, it provides me with an opportunity to deepen my ongoing relationship with the land; to observe what changes are taking place; to stop periodically at one or more of my favorite sit spots and just be. I'm also missing the winter. Last year was the warmest winter I can remember. There was pretty much no snow. This year we are having a somewhat more "normal" winter. I am missing walking through the snow; breathing the cold, crisp air; feeling the wind on my face; the calls of the chickadees, goldfinches and nuthatches. At best a couple of times a week when the conditions are good I can put the spiky snow things on the bottom of my crutches, go out and sit behind my house by our fire pit and gaze out over the landscape. I really do appreciate those moments.

"The Land" in winter.

Most of the details relating to the protocols that I am using have been covered in these first two parts of this series. From Part 3 of this series onwards I will discuss any changes that I make to these protocols and provide updates on how things are progressing.

The Pros and Cons of Vitamin Supplementation, Part 3 of 3

This is the third of three posts on this topic. Part 1 was posted on November 20th, Part 2 on November 22nd.

I would like to begin here by first clarifying some of the statements that I made in Parts 1 and 2 concerning manufacturers and retailers of natural health products. I referred to certain aspects of their formulating strategies as marketing gimmicks and also suggested that in some cases manufacturers were engaging in deceptive practices concerning the quality and forms of the ingredients in their products. Sadly, this is sometimes the case and it can be very difficult for consumers to discern the relative quality of products and information that are out there.

Before looking at some of the challenges for consumers who are looking for quality information and products, I would like to put this into a broader context. Natural healing practitioners and the natural health products industry have long been innovators in terms of challenging the status quo, developing effective therapeutic protocols, and making many excellent products available. Many of these very effective therapies and products have been ignored by mainstream medicine and often challenged as ineffective or even harmful. It is true that in some cases they were, but these challenges from reductionistic medical practitioners and scientists were largely based on a perspective that anything that is not backed up by clinical studies doesn't exist. The fact that a significant proportion of mainstream medical practices and uses of drugs are not supported by clinical studies doesn't seem to matter. What matters is that many proponents of mainstream medicine will attack anything that challenges their paradigm. Nevertheless, many of the medicines and methodologies that have been used by traditional peoples or developed by practitioners of natural healing have since been scientifically verified. When they are, the scientists who do the research often claim to have "discovered" these new treatments and don't acknowledge their origins or that they once vehemently denied their efficacy and the credibility of those who used them. That being said, just like any aspect of society where there is money to be made and ego gratification to be obtained, not everything out there in the natural healing and health products world is necessarily good for us.

Varro Tyler was a respected scientist considered to be one of the worlds leading authorities on medicinal plants. He once wrote that
mad-dog scullcap (Scutellaria lateriflora) is "a nearly worthless and essentially inactive plant". Recent research has begun to verify its
traditional uses. Any experienced herbalist that has ever used this herb knows that, stuck in his reductionistic, materialistic world view,
Tyler might have known a bit about the chemical constituents of plants, but he knew very little about medicinal herbs.

Back in the 60s and 70s, the natural foods and health products industry was largely made up of grassroots idealists who believed in what they were doing and tried their best to live it. Sure, there was still some questionable information and products out there, but most of it was pretty basic and sound. If we were to take a tour of the typical health food store at that time we would have found mostly staples, the essentials of a good diet: lots of unprocessed or minimally processed whole foods. The selection of supplements was for the most part pretty basic and uninteresting. What was sometimes lacking was a good variety of organic produce, meats and dairy products. Fortunately, organic agriculture has grown significantly since then and this is no longer the case.

In the late 70s and early 80s things began to change. The industry started growing at an incredible rate and the diversity of products increased similarly. On the food end, the shelves started filling with products that looked very similar to those on the shelves of regular supermarkets. On the positive side, this was an important indicator that natural products and healing modalities were becoming more mainstream and a growing segment of the population was starting to take their health more seriously. These products provided a lot more diversity and choices for consumers and they formed a very important bridge for people who were starting to change their diet, enabling them to purchase healthier products that were very similar to what they were already consuming. However, the downside was that the shelves of health food stores and eventually mainstream supermarkets as the momentum continued through the 90s were mostly filling up with slightly more natural and healthy junk foods. Although these products are better than their mainstream counterparts because they don't contain numerous additives and are usually made from mostly whole food ingredients, often organically grown, most of them are still for the most part processed foods. They are a healthier alternative but they are not whole, natural, unprocessed foods, which is ideally what our diet should consist of. You will find most of the real health foods in the bulk foods and produce departments of these stores, which of late tend to be taking up a smaller and smaller proportion of the floor space. I'm not saying that these products don't have any value. They are a step in the right direction and have lots of benefits over mainstream food products including those I mentioned above. I even eat some of them myself and recommend them to my clients to help them transition to a healthier diet. What I am saying is that many of these foods are not as "natural" as people tend to think they are.

Natural foods and health products are not on the fringe any more. They are mainstream and they are big business! In this industry it is almost impossible for small grassroots companies to survive these days. Most of the smaller companies have been swallowed up by medium sized companies or gone out of business. A growing number of the medium sized companies are being purchased by mega corporations. A significant portion of the industry is now owned by major food and pharmaceutical companies. This shouldn't surprise anyone because it is the same pattern that is unfolding throughout the global economy. These corporations aren't stupid. Natural foods and health products have been one of the fastest growing sectors and they want a piece of the pie, or all of it if they can get it! To this end, it's much easier to acquire an established company than to start from scratch. What this means is that natural foods and health products have arrived. They have been legitimized. In many ways this is a good thing, but what it means for this industry is that it is now infused with corporate values. Although many people that work in this industry still have a lot of the idealism that was characteristic of the past, a growing number of them aren't there because they believe in it. They are there because it's a good business.

With the infusion of corporate values into the natural foods and health products industry comes a lot of sophisticated strategies aimed at increasing the bottom line. Sometimes this translates into cutting corners on product quality. It has also resulted in some unscrupulous marketing strategies such as greenwashing.

One of the things that tends to characterize people who are interested in improving their health is their hunger for information. Companies in this sector have used this to their advantage by flooding the market with information on various dietary strategies, nutrients, herbs, and other related topics and products. It is not an exaggeration to say that most health-related information that is available in magazines and a significant amount in books is essentially advertorial of one kind or another. Some of the information might still be useful, but it is very difficult to determine what is good quality information when most of it is at best very biased, and sometimes completely inaccurate. To make matters worse, the people who consumers rely on for information, natural health product retailers, typically get most of their information from sales representatives, product literature, and a lot of those magazines that are publishing advertorials. I'm sure the majority of the people working in health food stores sincerely want to help their customers, but most of the information that they have access to is dubious and they usually don't have the necessary training to be able to filter out the good stuff from the bad stuff. Even natural healing practitioners often buy into a lot of the inaccurate information that is out there. This is particularly true of practitioners who sell natural health products because they are obtaining a lot of their information from product literature as well.

Once more I want to emphasize that I am not suggesting that most natural health products are poor quality or that manufacturers, distributors and retailers are deliberately trying to deceive consumers. Although it is true that a lot of the dubious information out there ultimately comes from someone who is attempting to manipulate consumers in order to increase their profits, most of the people down the line really believe that this information is accurate and helpful to people – and some of it is! The challenge is that most people don't have the tools to be able to assess the quality of the information. As an herbalist, I can honestly say that most of the information out there on herbs is inadequate and often inaccurate. However, unless you are an experienced herbalist you aren't going to be able to recognize this. Everyone can't be an herbalist. That is why one of the most important roles of herbalists is as educators. We need to get good quality information out there to help people to be able to make informed choices.

Now let's get back to the original point. It can be very difficult to determine what constitutes a good supplement regimen. On the one hand, we have extreme supplement advocates who, whether for business or ideological reasons or both, would have everyone popping hundreds of pills per day. At the other end of the spectrum we have old school reductionists and food purists who believe that supplementation is unnecessary unless a deficiency is confirmed. In between we have just about every other possible opinion.

In considering a person's nutrient requirements there are basically four different ways of looking at it:

1. Based on the minimum amounts required to prevent a deficiency disease. This perspective used to be common among medical doctors and dietitians. It is less so today as it is now clear that there are other negative health consequences that can be demonstrated when a person's intake of a particular nutrient is low well before the point where the symptoms of a deficiency disease will manifest.
2. Based on the amounts that occur in a "normal" diet of a "healthy" population. This is more typical of medical doctors and dietitians today. It is problematic because what is average is not necessarily what is natural or ideal. What is currently considered "healthy" by practitioners and advocates of mainstream medicine is probably not as healthy as they would like to believe.
3. Based on optimum requirements for overall level of health and well-being. This is difficult to determine and could vary considerably between different people.
4. Based on therapeutic doses. This is not something that should be advocated for daily consumption. When the dose of an individual nutrient is increased beyond the range that it is utilized for nutritional purposes, its action becomes less nutrient-like and more drug-like. Taking nutrients in therapeutic doses can be an effective element of an overall treatment protocol, but it is not nutrition.

Many medicinal herbs and spices, such as rosemary (Rosmarinus officinalis), are loaded with nutrients and antioxidants.

In my clinical practice I have found that what works best is to strive for optimum nutrient requirements. This should primarily be accomplished through eating a good diet as I discussed in the first part of this series. In particular, it means eating lots of vegetables and moderate amounts of fruit. However, for reasons that I stated previously, namely variations in individual requirements and the high levels of stress and toxicity that are endemic in contemporary Western society, I have also found that some level of supplementation is preferred if one wants to achieve some level of optimum health and well-being. The basic regimen that I recommend is as follows:

1. A low potency multivitamin and mineral supplement as I discussed in part 2 of this series, taken once a day with breakfast. This helps to ensure that we are getting what we need on a daily basis. The higher levels of B complex vitamins and certain minerals also help to address increased nutritional requirements due to stress, as well as provide some level of support for immune function.
2. To help protect our body from the harmful affects of toxicity and support immune function, I recommend some degree of supplementation with antioxidants. I primarily recommend vitamin C, 400-600 mg once or twice a day. If only taken once a day it should be taken with dinner to separate it from the vitamin C taken at breakfast as a component of the multivitamin. It is best to take vitamin C in the form of mineral ascorbates rather than ascorbic acid because the diet of most people in our society tends to be acidic and ascorbic acid will increase our acid load. Mineral ascorbates are not acidic. Calcium, magnesium or mixed mineral ascorbates are best. Sodium ascorbate is not recommended because we already tend to consume way more sodium than is good for us. It is also important that a vitamin C supplement contain a decent dose of antioxidant polyphenols, such as flavonoids, anthocyanins and proanthocyanidins. These are mutually synergistic with vitamin C. I also recommend vitamin E. 200 IU is sufficient for most people. It should be natural vitamin E, preferably in the form of mixed tocopherols. Vitamin E works best if taken together with 50-100 mcg of the mineral selenium. The vitamin E and selenium are best taken once per day with dinner. They must be taken with a meal that contains fat.
3. For people who live in the temperate regions of the northern and southern hemisphere, I recommend supplementation of vitamin D. Typically, I recommend 2,000 IU per day from October to March (April to September in the southern hemisphere), and 1,000 IU in April and September (March and October in the southern hemisphere). Anyone who does not spend much time outdoors should take 1,000 IU in the summer as well. However, anyone who wants to implement a healthy lifestyle should try to spend as much time as possible being active outdoors – in a natural setting as much as possible. For vitamin D production and many other reasons, it is best not to wear sunglasses all of the time when outdoors during the summer. Sunglasses aren't good for our eyes anyway. Of course, these recommendations are reversed for people living in the southern hemisphere where the seasons are opposite. Also, keep in mind that requirements of vitamin D supplementation is going to be lower at high altitudes and higher for darker skinned people. It's also going to be lower for people who traditionally eat foods that are high in vitamin D such as fish liver.
4. In the contemporary Western diet, the fat content of our diet tends to be high in saturated fats of animal origin and plant-based oils that are high in omega-6 fatty acids. Ideally we need to reduce these and increase the proportion of monounsaturated and omega-3 fatty acids. Traditionally, animal fats in our diet came from seafood or wild game and livestock that ate a natural grass-based diet. Today, livestock are primarily fed an unnatural diet designed to speed up their growth rate and fatten them up. They are also a lot less active. The result is that their tissue contains more fat and it is primarily saturated with very little omega-3. Consumption of large amounts of fish and wild game is no longer recommended due to environmental contamination and ecological issues. As a result, the easiest way to increase omega-3 consumption is through the use of plant-based vegetable oils. By far the best source is organically grown, raw flax seed oil that has been processed without exposure to heat or oxygen, stored in dark bottles and refrigerated. Other plant sources tend to have lower levels of omega-3 relative to omega-6, monounsaturated and saturated oils. Consuming nuts and other foods that contain them is still good in moderation. Olive oil, which is a mostly monounsaturated oil, has been found to have many health-promoting benefits as well. Nevertheless, we still need to increase the omega-3 oils in our diet and flax seed oil is the best option. I don't recommend fish oils because they are subject to environmental contamination and because of the way they are processed they tend to be rancid. Although the negative health consequences of consuming rancid oils has been given less attention than trans-fats and animal source saturated fats, it is almost certain that rancid oils pose almost as much of a health threat as trans-fats. The other issue with fish oils is that several major studies that have looked at the amount of fish and other marine animals that are being harvested from the ocean have unanimously concluded that commercial fishing at anything close to current levels is completely unsustainable. The omega-3 issue has been given a lot of attention in recent years and many foods are now claiming to be "fortified" with omega-3 oils. This is another marketing gimmick. Omega-3 oils are extremely unstable in the presence of light, heat and oxygen, and adding them to various processed foods means that they will be rancid. As a result, I recommend a dietary supplement of 1-2 teaspoons of good quality flax seed oil per day. This should never be cooked but can be added to cooked foods on our plate as long as they are consumed right away. It is important to recognize that consumption of polyunsaturated oils increases our daily requirements for vitamin E and selenium.

This is the basic supplement regimen that I recommend. In my life and my practice I have found it to be a very useful adjunct to a good diet and healthy lifestyle. It is not going to meet everyone's needs exactly, and I sometimes recommend additional supplements or higher doses for specific issues. For example, anyone suffering from chronic auto-immune or inflammatory conditions will benefit from higher doses of vitamin D and antioxidants, especially ascorbate and polyphenols.

Blueberries are a very rich source of polyphenols such as anthocyanins.

We can also increase the antioxidant content of our diet by increasing consumption of leafy green vegetables, and fruits and vegetables that have a deep orange, red, blue or purple colour. It is not necessary to consume exotic "superfoods". This is also a marketing gimmick. All plants are anti-oxidant to some degree. It's true that some are considerably more antioxidant than others, but pretty much no matter where we live their are fruits and vegetables that are very high sources of antioxidants. For instance, it doesn't get much better than dark blue and purple berries like black raspberries, blackberries, blueberries and bilberries, which grow and are cultivated throughout the temperate regions of the northern hemisphere. It doesn't make sense to consume exotic plants from foreign countries where we don't know for sure whether they are destroying the environment when growing or wild-harvesting them, they must be transported long distances, and they are usually a lot more expensive.

That is my take on supplementation. It's not going to be perfect for everyone, but it's a good basic template which we can work with and fine-tune in order to meet our individual needs. Of course, there are lots of other opinions out there. All I can say is that these recommendations are supported by the limited research that is available, and more importantly, I have found that they work in my life and my practice.

More Support for Exercise!

OK, so I've been an absent parent for awhile and this child of mine is feeling somewhat neglected. The last few months have been really busy and it's easy for me to forget about this blog. It's not something that comes naturally to me.

Things haven't changed that much. I'm still really busy. In the last couple of days I harvested and prepared the following macerations: 2 litres of fresh common burdock root (Arctium x nothum); 6 litres of fresh marshmallow root (Althaea officinalis); 7 litres of fresh maidenhair tree leaf (Ginkgo biloba); 9 litres of fresh rosemary leaf (Rosmarinus officinalis). Welcome to the life of an herbalist!

Common burdock (Arctium x nothum).

So now lets get to the point of this posting. Here's some information on an interesting study that was recently published:

http://www.scientificamerican.com/podcast/episode.cfm?id=exercise-lengthens-life-regardless-12-11-06

This is another study that on some level is verifying the benefits of exercise. Unfortunately, the focus of the study was on life expectancy rather on quality of life indicators. Nevertheless, life expectancy is potentially an indirect indicator of other things. For instance, presumably a big part of the reason that the people in the study who got more exercise lived longer was because they were experiencing a lower incidence or later onset of the kinds of things that can kill us. Those kinds of illnesses also reduce our quality of life. So, some level of increase in quality of life can possibly be inferred. It is, however, possible that some of the subjects got sick with the same illnesses, but they developed more slowly to a level that produced mortality. So it is still possible that some of these people were chronically sick. This wasn't covered in the study but would have been a good parallel line of enquiry that they could have pursued. It is also possible that they did collect this kind of data but haven't analyzed and/or published it yet.

There's a lot of research on the benefits of exercise and these results are to be expected. However, there was one very interesting finding that resulted from this study. The researchers found that people who are obese who exercise regularly live longer than people whose body weight is in the normal range but don't exercise. This is a very important result because it means that for many people inactivity potentially has a greater negative impact on their overall level of health and well-being than obesity. Of course, in the real world the situation is far more complex than that. For instance, inactivity is one of the major causes of obesity. But there are many people who are overweight that exercise regularly and still have difficulty losing weight. There are a lot of reasons why that might be the case, but the important thing here is that they will receive health benefits whether they lose weight or not. It is so easy to get discouraged when we don't see the visible benefits of exercise. The results of this study are an encouragement to keep at it because the benefits are real even if they aren't visible.

Although in the last few decades there has been a growing number of people in our society who are taking positive steps to implement a healthier diet and/or lifestyle into their lives, we still have a growing segment of the population that are overweight or obese. This is primarily due to diet and lifestyle issues, although we can't ignore the deeper psychological, social and spiritual reasons why people make the kinds of choices that they do. On the surface it is obvious that the typical modern lifestyle is way too sedentary. Our bodies are designed to be on the move most of the time. Things that are misused usually break down. Unfortunately, even among the more health conscious members of our society, there tends to be two distinctive camps: those who try to eat good quality natural food but rarely exercise, and those who get lots of exercise, play sports and eat crap. Diet and exercise are two sides of the same coin. Living a healthy life means eating well and being active. That is why the Harvard Medical School Healthy Eating Pyramid has daily exercise and weight control at the base of the pyramid [See: http://www.hsph.harvard.edu/nutritionsource/files/Healthy-Eating-Pyramid-handout.pdf]. This pyramid represents the best dietary and lifestyle choices that can be recommended based on the research that is out there.

The bottom line is that the modern Western lifestyle is far too sedentary. We need to spend less time sitting at a desk, in front of a computer, watching television, playing video games and driving around in our cars and SUVs; and a lot more time walking, hiking, playing sports and working out. As always, the difficult part is changing the old unhealthy patterns and replacing them with healthy patterns. Once the new patterns are established it gets a lot easier. Most people don't realize how bad they feel until they start doing things that are good for them and feel the difference.

It is also important to keep in mind that we aren't going to be able to maintain a healthy activity and lifestyle regimen if we don't enjoy it. We need to experiment a bit until we find the kind of exercise that we like if we want to be able to sustain it in the long run. Being in nature is always healthy and healing. We spend most of our lives cut off from the real world. So if getting out in a natural environment is an option I highly recommend it.

Sasha doesn't need to be convinced that exercise is good for her!

Before I sign off on this one I'm going to rant a bit on another issue that this study has brought up for me. I do take issue to some degree with the fact that the primary parameter that they are looking at is life expectancy. Our society is obsessed with wanting more of everything without any consideration of quality or consequences. Life expectancy is no exception. Most of us are so afraid of death that we will do anything to extend our life at almost any cost. I don't see any point in living an extra 10 years if we are going to spend it in a nursing home pumped full of drugs. What kind of quality of life can we expect when we force our body to continue functioning beyond it's expiry date? Of course, it is likely that we will live longer and be healthier if we live according to healthy principles. Extending our life naturally by living and eating in a way that promotes greater health and well-being is not the what I'm addressing. It's amazing how much money is pumped into "longevity" research, seeking ways to extend life at any cost. This has got to be one of the most absurd and selfish things that I can imagine. We are already over-populated and a large (and growing number) of us are significantly over-consuming. The goal of our economic pundits and the multinational corporations that they serve is to produce endless amounts of junk as cheaply as possible and make sure that everyone is consuming as much as possible. It doesn't take very much intelligence to realize that this is unsustainable. We are quickly eliminating all of the resources that our children and grandchildren will need in order to survive, not to mention all of the other beings that we share this beautiful planet with. If we find unnatural ways (drugs, stem cells, genetic manipulation, etc.) to increase average life expectancy by 10 or 20 years we will be taking even more from future generations. How about we just learn to be satisfied with what we have and live our life to the fullest? In our society we need to learn to embrace our death; to learn from it instead of pretend that it isn't going to happen. Our lives will be so much fuller and more rewarding if we learn how to live and die with dignity. To live a healthy, well-balanced life, we need to integrate the bigger picture rather than to live our life as if we are the centre of the universe. Of course, whether we intend it or not, our last act of generosity will be to nourish the fungi and bacteria that create the soil for the future benefit of all living beings!

Turkey tail (Trametes versicolor) is a medicinal mushroom that eats wood, not human remains.

But who knows what the tree was eating?