Below is a case example to bring to life this model of therapeutic order. (Note: names changed to protect patient privacy)
Katie is in her early 60’s and came into my office complaining of , , , and menopausal symptoms. She was exhausted to the point of having to nap most of the day. To complicate things, her daughter, Didi, is developmentally disabled and needs help day and night. She never gets a day off from caring for her.

Looking at her determinants of health, Katie’s genetics are partly the cause of her high blood pressure and cholesterol. These are chronic conditions that will be managed more than cured, most likely.

Her life disturbances are chronically broken sleep and lots of stress in her home life.

Her lifestyle is rather sedentary. These factors are curable. She has a satisfying marriage and is supported by her church community. Her environment is clean and her is decent, though could use some tidying up. Her prognosis is good.

Didi, Katie’s daughter, is in her mid 30’s and was born with congenital brain abnormalities. She has the IQ of an average 2-4 year old. Her main health issues were episodes of severe headaches with vomiting, some behavior issues, and insomnia. She is well taken care of and has the love and support of her family and church community.

In order to help re-establish the basis of health for Didi and Katie, I began by gathering information. At the first visit, I did a thorough, hour-long interview with both of them, basically getting their life stories and physical complaints from head to toe. I ordered some screening lab work and did a brief physical exam.

Didi’s labs showed low . She has hypoglycemia! None of her doctors in the past had checked her fasting blood sugar. After Katie changed the way she fed Didi by letting her have healthy snacks whenever she was hungry rather that having her wait until meal times, everything got remarkably better. This one simple change resolved most of Didi’s issues. She has been able to avoid taking the prescription medication for vomiting and headache episodes because she doesn’t have them anymore now that her blood sugar is balanced by diet.

Because her daughter is feeling better, Katie is now able to sleep for longer stretches, is under less stress, and therefore is enjoying improved health and less fatigue. We are still working on helping her transition through menopause and deal with her genetic risk of heart disease. Her hs-CRP, a marker of inflammation that is indicative of increased risk of stroke and heart attack, was sky high at the first visit and is now near normal after 6 months of us working together, so we are making good progress. We meet every 4-6 weeks to monitor her treatment progress and for , which help her relax and relieve muscle tension.

I share this case example with you to illustrate how basic and simple lifestyle changes can make a huge difference in people’s quality of life. Also, by treating the whole family, improving the health of one has a ripple effect, or butterfly effect, that benefits the whole. This is an example of how starting with the basics, the first rung of the naturopathic treatment ladder, is sometimes all the treatment intervention necessary- as in Didi’s case. For her mom, we are treating her with several rungs of the ladder of treatments. In future posts, I will reference the therapeutic order again to show you how naturopaths approach other types of health conditions.

Margaret Philhower, ND