Initial Evaluation – What to Expect


Arkansas Nutrition and Natural Healing

Dr. Roger Trubey, Dr.PH, MPH, and Doctor of Integrative Medicine 362 Unger Trail, Mountain Home, Arkansas 72653

Call 501-538-4944

I often find that many new patients have never been to a Naturopathic Doctor previously.

Some have always used natural remedies that they learned from mom or dad or they just knew intuitively that it was the best place to start.  Others, having used a more traditional route with conventional doctors, came to see me because their chronic issue(s) was/were not being resolved.

I always start with a thorough history.

So I always ask “what is your primary health concern?”   Sometimes it is only one concern but often it can be three or four.   What is important to you is very important to me so I want to know as much about your problem(s) as you can provide.  I want to know how long you have had symptoms, how long ago you were given a diagnosis (if you were given one) and I want to know what makes the problem better or what makes it worse.  It is important for me to know if there was some event in your life that preceded the onset of symptoms.  Was there an illness, like a flu that preceded the onset of symptoms, or did it begin with a travel event, auto accident, or a major stress of some type.  These are clues that may be useful in determining the underlying cause(s).

The underlying cause or causes is far more important than having a diagnosis and most patients do recognize this.

Sometimes the event that started the problem was only a trigger for a deeper underlying cause – like a serious cold or flu that awakens a dormant, but more serious chronic infection.  Or an automobile accident that weakens the immune system and awakens a smoldering and chronic infection to a more significant level of activity.

We can take a pain reliever for a headache and while it may relieve the pain, aspirin or Tylenol deficiency is not the cause of the headache.  I want to know what that cause is.  Sometimes the underlying cause was not the precipitating cause and I need all this information to try to distinguish the two.

The problem most patients have with chronic disease today is that in conventional medicine, the underlying reasons for the disease is never really assessed.  Chronic viruses, the Lyme spirochete, mold toxins, food sensitivities, gluten, chemicals, pesticides, herbicides, damaged or leaky gut, parasites, adrenal and mitochondrial dysfunction and much more are, for the most part, ignored, or worse, scoffed at and ridiculed.  But today, all chronic diseases have one or more of these underlying factors and they must be uncovered if we are to get long-term relief of chronic illness.  The body always wants to heal but it is generally necessary to remove some blocking agents to allow the body to accomplish its goal.

I also want to know what you are eating and drinking during a typical day.

This will provide further clues so that I can give you the best possible advice to improve your health.

I will also ask about dental interventions.  I want to know if you have had any root canals, dental restorations and the materials used.  I will want to find out if your gums bleed or if you have periodontal disease.  What happens in your mouth has a great deal to do with the health of your body.   All of our teeth (or spaces where a tooth was) are on a specific acupuncture meridian and connected directly with specific organs of the body.   Any inflammation, dental material, or infection can have a potentially toxic influence in a tissue far away from that tooth.

You will be asked about supplements you take and any prescription drugs you are using. 

It is not unusual for some of the symptoms patients are complaining of to be the same as the side-effects of the drugs they are using.

And, as you could guess, I do want to know what stresses you may have in your life and how much of a stress these are, how long you have been dealing with them and if you are having trouble coping with them, when you expect any resolution, if at all.

I have all patients complete a detailed information questionnaire that will ask about many areas for which you may or may not have symptoms.   I will send this to you in advance so that you can complete it at your own pace prior to our appointment.

If you have had any lab work completed in the last year or two, I encourage you send it to me before this this first evaluation and I will review it with you. 

I often find key blood parameters that are missing or ones that were abnormal and the patient was never told that it was a potential problem.  Knowing this previous data is very helpful to me in evaluating any changes in a particular parameter over time that is in need of attention.

Much of our health is determined by our start in life.  Yes, our genetics will play a role and while we can’t change our genes, we can control how they are expressed and that is the epi-genetics.  Epi-genetic factors are those nutritional, environmental and even emotional factors that will determine if a gene is expressed on not.  So, having a gene variant for breast cancer does not mean that it has to be expressed.   There are generally several factors that are working to inhibit the expression of a gene and likewise others working to express a gene.  So eating a lousy diet, not getting any healthy sunlight, being a “couch potato” with lots of stress will encourage the expression of that gene.  But likewise a healthy diet with adequate nutrients needed for breast tissue with exercise and a happy outlook can go a long way to prevent the expression of that gene.

So with that in mind, our start in life is very important, so I ask if you were born vaginally or by C-section and if you were breast fed and, in addition, if you were given lots of antibiotics.  These are critical factors in determining the health of our intestinal tract.  You see, changes in our intestinal microbiome can have effects that not only last our lifetime but can be passed on to successive generations.  And a damaged gut is the foundation for the majority of our chronic degenerative diseases.

Finally, I will ask about flu vaccinations, if you have had them, breast augmentation for females, later history of antibiotic use and if you have had an exposure to mold at home or at a place of work.

After I have all this information, I may make recommended changes to your diet and to suggest changes to your nutritional supplements.  I may further suggest life-style changes to improve health outcomes and I will likely recommend specific tests that you should consider to give us a more complete picture of those underlying causes that are preventing you from having the level of health that you desire.   Before I do this I will often ask “Now what would you like for me to do for you?”   This gives me the assurance that I am focusing on exactly what you want to have done for you.  Most of the time patients will leave with a written and detailed plan to guide them in facilitating their health objectives.

Generally, the initial visit will take 1 1/2-2 hours. 

So please plan accordingly.  As a general rule, children can be a partial distraction and I encourage patients, if at all possible, to have this time free from their need for parental or grand-parental attention.

If you have any questions or concerns you need to discuss with me ahead of a potential visit, I am very happy to do so.  Just call me at 501-538-4944

Thank you for your interest in coming to see me, Dr. Roger Trubey