Walking.  We figure out how to do it after crawling for a while.  We do it for decades without a second thought.  We skip and run, we carry loads and climb ladders and live life on two feet.  Walking is effortless.  

When an injury happens, suddenly walking isn't so easy.  We must learn how to walk again, step by wobbly step, using crutches, rails and the strong arm of a friend. Over the years our injuries accumulate.  It isn't many few decades after we stop crawling that we begin to stiffen up and slow down.  Arthritis brings persistent pain into our paces.  

Healing is spontaneous most of the time, and sometimes we get knees repaired or joints replaced.  When walking isn't so easy, we appreciate just how important it is.  Our ability to walk is part and parcel with our lives.

Walking speed correlates directly with life expectancy in our later years.  Fast walkers live longer.  Overall, not in every specific case.  When congestive heart failure (CHF) strikes and we are confined to our beds, walking can save us or kill us.  Research has shown that most people with CHF get better when they begin a program of walking.  A few individuals have worse outcomes, early, the rest of have better outcomes, period.

Walking is a test and if you pass, you live.

I never would have thought I'd say that.  When I was a BLM ranger in California for a summer, I covered myself in DEET to work in clouds of mosquitoes, and I thought it made me sick.  I was so eager to wash that stuff off at the end of a workday!  But it does work on bugs.

Recently I did a 6 day kayak self-support trip on the mighty Yampa river in northwestern Colorado.  I got sick when I got home.  BAD sick.  I think I had West Nile virus, and that it infected the meninges of my brain.  But I am bouncing back, finally.  The only upsides I can detect is that I lost some weight that I didn't mind losing, and that if I did have West Nile, I won't be getting it again.

A couple days ago I read the recent missive of the EWG (Environmental Working Group) about bug repellants (which we didn't have).  They pretty much said that the herbal ones don't really work, and with stuff like West Nile and malaria out there, you want one that works.  Hence the DEET recommendation.  I have more research to do about it because I hear that there's another chemical that may be less toxic to humans and work as well as DEET, but I don't know it yet to report on it.  I've heard that the clothing that is impregnated with bug stuff really works well too, so if I ever go "Yamping" again I'll take some of that.

Suffice it to say that I really recommend avoiding mosquito bites this season.  Apparently it's a bad West Nile season in Colorado and in Oregon, because of the mild winter and warm spring.  It's probably bad nationwide.  And the disease that can be caused by West Nile is sorely unpleasant.  Don't get it, but if you do get a big fever and headache after mosquito bites, get naturopathic support.  Conventional docs will just tell you to take ibuprofen or acetomenophen and go to bed.

My patients often ask if I think medical marijuana might be helpful.  We’ve had some widely ranging conversations about the risks and benefits of this drug.  As a naturopathic physician I may not prescribe cannabis even though it is legal for medical use here in Oregon; it is not in the ND formulary.  The fact that I cannot prescribe it does not prevent me from discussing it.  The issue will not go away, regardless of the laws and the war on drugs.  Cannabis is ubiquitous, even though it is federally illegal with varying levels of state permissiveness.

Just last month Colorado and Washington were the first states in America to approve the legalization of marijuana for recreational use.  Those who fear it as a gateway drug, and those who advocate its medical use or broader legalization, are all making noise about it.  The politics often plays more loudly than the facts.  Marijuana is the #1 drug brought our way by Mexican drug cartels, and Mexican weed is likely to contain pesticides and other toxins.  Synthetic cannabinoids are being imported from Asia labelled as bath soaps and sold in convenience stores.  The war on drugs highlights our incarceration problem and the ugly politics of race.  Reasonable medical questions remain unanswered.

Our own government propagated a lot of disinformation back in the 1930’s when the Federal Bureau of Narcotics was created and cannabis was classified as a narcotic (against the advice of the American Medical Association).  The original Greek meaning of “narcotic” was any psychoactive substance that induces sleep, but in more recent times it has come to mean opiates and any drug derived from them.  Opiates are addictive and are carefully regulated by the DEA.  Cannabis is pharmacologically a world apart from opiates, and is no longer thought of as a narcotic, but it is still plagued by the negative reputation engendered by federal prohibition and propaganda, and the War on Drugs.  Cannabis was federally prohibited in 1933, the same year that the prohibition on alcohol was rescinded.

In 2009 the AMA did a review of the scientific literature on cannabis and found a few legitimate clinical trials with a grand total of less than 300 study participants.  The DEA has refused to grant permission to universities or pharmaceutical companies to research it.   The drug is approved by 18 states for medical use, but we have very little scientific information on which to base clinical applications.  Anecdotal information about the indications of various strains guide the choices of medical users.  The federal ban is still in effect, and current federal enforcement efforts are focused on importers and distributors and not on small scale possession (like they were under Reagan).  Employers are within their legal rights to require drug testing.  Law enforcement budgets rely on asset forfeitures (police can seize any cash or items likely to be related to drug trade without proof of guilt) which is incentive for police forces to continue to pursue small scale dealers.  Medical cannabis programs provide a front for a new domestic black market.  That the issue is contentious is an understatement; it is explosive.  And we still don’t know what it is good for.

A future email newsletter will focus on known and theoretical risks and benefits of cannabis use.  Sign up for the monthly missive here. 

 

After taking boards in August, I went on a series of adventures.  As you may know by now, my favorite form of outdoor recreation is boating down whitewater rivers.  I got to run the Rogue River here in Oregon for the first time, and returned to Arizona for another trip down the mighty Colorado River through Grand Canyon.  Our Grand Canyon adventure was 21 days long; a very long time to be away from cars, money, electricity, and everything else modern.  I love that.  On both trips I was rowing a raft.  I enjoy rowing in part because it strengthens my core and makes me feel awesome.  I had let myself get soft while studying for boards, and I feel much stronger after these trips.

While we were away my board results came in.  My mail was on hold so it wouldn't pile up in the mailbox.  When we got home I fell to the project of unpacking and cleaning up.  My partner asked me "Are you going to open the mail?" and finally I did.  I expected to pass, but the way those exams are, you never know for sure until you get the results.  Thankfully, I passed with room to spare.  I'm done running around on major multi-day river trips for now, and well rested to tackle the paperwork involved in starting up my practice.  Here goes!!!