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How to Self-Advocate for Your Health - Part 1

Updated: Mar 22, 2023

The Self-Advocacy Framework: How to simplify your research and process so you know what to look/ask for, who to ask it to, and how to access it

In my last post I mentioned why it's crucial that you take charge of your own health care because the system and your medical practitioners aren't trained or incentivized (or even allowed) to treat you as a whole person. The part of your health care they excel at is a very important, but small, slice of your health care needs.


Your health care needs are numerous and holistic, and figuring out what they are and how to meet those needs can be overwhelming. It's helpful to have structure to limit the endless possibilities and organize your search. So before we start getting into how to do your research, I want to first cover what you should even be looking for in the first place, and how to organize it.


There are 3 elements to the self-advocacy framework I have created (see picture above):

  1. What it does to your symptom/disease. Is it symptom relief, anti-inflammatory, or regenerative? (symptom relief is not on the picture because it's already the default)

  2. The type of care that it is. How does it resolve your condition? Is it self-care (something you do on your own), lifestyle support (a behavioral strategy with the help of a lifestyle practitioner), tests or treatments (e.g. procedures, medications, etc.), or regenerative medicine?

  3. How you access it. Can you get it on your own, through an allied health provider, or through the healthcare system or a specialized private clinic?


Symptom-Relief vs Anti-inflammatory vs Regenerative

Why is it important to differentiate by what it does to your symptom or dis-ease?


Because symptom-relief will only address the surface but all the while the underlying issue, or root cause, might be making your condition worse over time or cause other complications and your symptom-relief will no longer be effective.


It is well-understood by now that most chronic conditions and diseases are caused by systemic chronic inflammation. Not the good kind that occurs when you hurt yourself and then your wound swells up while it heals (that's acute inflammation). But the type that occurs without you knowing, inside your cells, all the time, that tells your body there is something that needs to be attacked and activates your immune system. Inflammation is why you develop pain, weight gain, sleep issues, digestive issues, neurological diseases, metabolic diseases, cardiovascular disease, autoimmune diseases, cancer, etc. This is a very long process of deterioration until it shows up in "symptoms" or what we call "disease".


Modern medicine has made many inroads to considering inflammation in recent treatments, such as migraine medications (and of course chemotherapy and autoimmune medications suppress the immune system because it is the immune cells that have gone hay-wire). However, we could think of inflammation as a symptom and a root cause. Your diabetes might be caused by inflammation impacting your insulin sensitivity (cause), but what is causing the inflammation in the first place? Sure, genes play a role, but more importantly, what environmental factors triggered those genes and caused the inflammation to occur?


The best strategy for your symptoms/conditions is to address all of these levels in parallel. Symptom-relief is crucial when your symptoms are debilitating, such as migraines or arthritic pain or insomnia. So you will want to address this first, but then you should also address the inflammation (preferably without causing other problems).


There are anti-inflammatory medications such as ibuprofen and NSAIDS, and these can be helpful, however, that is not the anti-inflammatory effect I am talking about, for 2 reasons. One, they have important side effects (NSAIDS and ibuprofen, notably in the gut) so you can't take them for a long time. Secondly, they don't stop the inflammation at the root, only relieves it when it does occur.


Anti-inflammatory strategies usually target stopping the inflammation from occurring in the first place. They include lifestyle modifications such as improving sleep, incorporating more movement, nutrition strategies (anti-inflammatory diet), removing toxins like smoking and alcohol and other chemicals in home and body care products, as well as supplements or medications such as turmeric, omega-3s, or hormone-replacement therapy, etc. These usually address the digestive system because so much inflammation originates there (70%-80% of the immune system cells reside in the gut!). They also usually address stress, because stress is the number 1 driver of inflammation (cortisol activates the immune system).


Regenerative strategies involve a variety of care types, including lifestyle and self-care strategies like exercise/movement rehab, even sleep, but usually involves cellular healing and regeneration using cellular genetic therapies, surgery, or special mechanistic interventions such as hyperbaric oxygen therapy, platelet rich plasma, and prolotherapy which is accessed through healthcare professionals of some variety (sport medicine MDs or physiotherapists or specialty clinics). When it comes to arthritis or diseases where tissues are degraded and damaged, and repair is difficult, regenerative medicine offers the hope that the damage can be reversed.


Type of Care

Once you know what a treatment does to your symptom/condition, you can group them in terms of the type of care that it is and where to fit it into your life and treatment plan. You can also do them all simultaneously and thus increase your chances of success.


For example, self-care is mostly stuff you can do on your own, and that can be either symptom-relief (CBD oil for pain), anti-inflammatory (turmeric or omega-3s) or regenerative (neuroplasticity movement exercises).


Lifestyle support can also be symptom-relief, anti-inflammatory or regenerative. Consider a low-FODMAP diet for IBS or a blood sugar/ketones tracking device for example (symptom-relief), counseling or movement (anti-inflammatory), and sleep coaching (regenerative).


Tests can point to the underlying pathology but sometimes those are underpinned by something else going on in the body. For example, if you test positive for SIBO (small intestinal bacterial overgrowth), which is the cause of a large proportion of IBS cases, it might show you why you have IBS, but it won't tell you what caused it in the first place and whether there is another underlying viral infection or hormonal dysfunction that caused or aggravated it. For example, low thyroid slows down gastric motility, which can then allow fermentation to take place and allow SIBO or candida overgrowth to develop (in which case, thyroid would be a root cause, and SIBO would still be a symptom).


In the same way, treatments can also address symptoms (e.g. muscle spasming for IBS), or the SIBO infection (e.g. anti-microbials), and/or the hormonal imbalance (e.g. thyroid replacement - although you could also argue that there might be something even deeper that caused the low thyroid, such as having insulin resistance or eating too few carbs for too long, or unresolved trauma, etc.).


Regenerative medicine is quite rare in the conventional medical space, sadly. Most treatments, whether medications or surgery or radiation etc. address the visible signs of disease which are never the starting point or reason for the disease to have occurred in the first place. Here I am talking about things like bone, joint cartilage or ligament healing and regrowth, pelvic floor lining thickening, the pancreas regaining capacity to produce insulin, eliminating chronic viral infections (not just repressing them), repairing burn or scar tissue, laser eye surgery, etc.


Sometimes the best you can hope for is that your disease does not progress and your symptoms mostly resolve (but the damage done stays there), but sometimes you CAN reverse the damage done with surgery or injections or hormone replacement or cell genetic therapies, etc. Sometimes this is medical practice that has been available and practiced for decades (such as prolotherapy), and sometimes it is very new (like cell genetic therapies for cancer).


The beauty of having your research organized in this way (according to what it how it works in your body and what type of care that it provides) is that you can then pick and choose from each category and decide when to do each one. There is no reason that self-care can't happen in parallel with all the other types of care you seek, like lifestyle support and tests and treatments. You might even start with that, and lifestyle support, and if your symptoms don't resolve, then you seek out medical help. Or you do it all at the same time and ask your medical practitioner to monitor your biomarkers with testing as you implement various strategies. But you can keep track of the various modes of treatment and this way increase your chances of success.


How to Access

Self-care is as it sounds: self-accessed. You can usually get this on your own, either through retail pharmacies and online retailers, online courses or trainings, or going to the sauna or spa. You have to pay for this yourself.


Lifestyle support is usually accessible through allied health providers such as dieticians or nutritionists, health or exercise coaches (including sleep coaches), psychotherapists, physiotherapists, massage therapists, osteopathic doctors, chiropractors, acupuncturists, pharmacists, or complementary/alternative medicine practitioners such as functional medicine or integrative medicine practitioners, naturopathic doctors, herbalists, energy medicine practitioners, etc. Allied health providers and naturopathic doctors are often at least partially covered through employee health benefits or other wellbeing benefits but not always. (Dentists and optometrists are usually covered at least in part by the majority of health benefit plans). You may have to pay some or all out of pocket for these. Sometimes you can demonstrate to your employer the benefit to them (through better health outcomes for you) of adding a practitioner to the list of paramedical providers or of your EAP at no additional cost to them. Just note that in order for your employer to add a practitioner, they usually have to be licensed by a regulated college in your province (insurance contract rules).


Tests and treatments are usually accessible through your medical provider (i.e. doctor), however, naturopaths and also pharmacists in some cases can order tests. You can also often order these online (but you have to pay for them yourself), such as the SIBO breath test, or now you can even do blood finger prick tests that measure several biomarkers such as sex and stress hormones, metabolic, and inflammation markers.


Some tests or devices may require a prescription. Most tests at the lab that your doctor sends you to do are free, but there are some which are only paid for in cases of a particular diagnosis or other test result (e.g. Vit D is only covered in Ontario if you have osteoporosis or other bone-related conditions or renal disease). Certain tests such as for SIBO are only covered in few centres across the country (usually in hospital GI specialty centres). The number of tests offered at most lab centres is growing with increasing scientific research but not all get added to coverage (or it just takes a really long time before they do). Genetic tests is one example, either in the context of identifying drug reactions and responses by individual patients, or to establish eligibility to certain medicines or procedures (this is common in cancer).


In the majority of cases, medications require a prescription. (Note that naturopathic doctors are also licensed to prescribe medications.) The prescription itself is free when provided by your doctor (because physician services are covered by provincial health insurance), however, the prescribed medications themselves are not included in your provincial health insurance. But the vast majority of employer health benefit plans will cover a large number of drugs (unless it's very new and/or very expensive - in which case you may be forced to take the cheaper option or else pay for the difference yourself). If you are a senior or have lower income, or have a special disease (or you need it for your children), depending on your provincial drug programs, you may qualify for provincial drug insurance, which usually includes a smaller list of drugs (mostly older and cheaper drugs) but may still require a significant co-pay, deductible, or premium. If you are self-employed or a business owner then you need to pay for this out of pocket or buy your own private insurance.


Anything you receive in a hospital or centres affiliated with a hospital centre is most of the time covered by provincial health insurance. If it's a medication, procedure such as a surgery or diagnostic like a mammogram or colonoscopy (even if it's an outpatient procedure), it's free. If you are discharged however then anything they gave you in hospital that you need to keep taking (such as a medication, again, depending on where you live), you may have to pay for yourself (or through your private insurance).


Community care such as home care or long-term care, or even mental health counseling services are sometimes covered by provincial health insurance but this is minute and reserved for extremely sick or severe patients/cases, and for the vast majority of individuals these are paid for out of pocket or by private insurance through private practitioners or institutions. If you are discharged from a hospital and are flagged as high-risk, then you are more likely to be matched to publicly-covered community care services.


As you can see, healthcare is complicated, fragmented, and extremely localized, despite its universality of standards, etc. Accessibility and affordability are serious issues in Canada, despite "free" healthcare - since many services are not covered under provincial health insurance. In some ways we are actually more like the US than European countries which have nationalized medical insurance as well. But that is a topic for another day (and for my upcoming new book!).


In Summary

Once you have your research categorized according to this framework, it will be very easy to know what to do/get, who to ask for it, and how to access and pay for it. Now the question is, how do you do the research?


Yes, yes I'll get to that. Stay tuned for the next blog!


Visit my Tier 1 Self-Advocacy Toolkit page to find out about how I can help you uncover possible root causes and outline new possibilities, quickly and affordably: www.rootedskysolutions.com/tier1toolkit. Contact me at sarah@rootedskysolutions.com if you have several health concerns and I can do a deeper dive for a customized cost.


If you like my writing and would like to "borrow" some of my material or would like a similar piece written to your audience please contact me at sarah@rootedskysolutions.com.



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