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All posts by All Paths Naturopathy & Midwifery

Out of the Office.

David and Dr Amanda will be out of the office on Monday November 10.  We are at a learning collaborative.  We are learning how to better support all of you.  Thank you for your understanding.  Scheduling calls will be returned on November 11.  Have a great day!

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Online updates

Thank you all for your patience during the website updates and for the delay in posting.  There has been a lot of inner reworking going on at the office in attempts to better serve you.  Some of you may have noticed invitations to Patient Fusion in your email.  This is the patient portal associated with our electronic medical records soft wear.  The portal allows you access to treatment plans and labs.  If you need assistance, please let Dr Amanda know at your appointment.



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Fig Pear tart

Today our recipe is for a pear and fig tart. With the crispness which has crept into the morning air I have been reminded of autumn in western New York.  Fall foliage colored in reds, orange and yellow.  The air scented with cider donuts, apples and spices including cinnamon and clove.  It used to be apples that heralded the change of the seasons, but here in southern Oregon, I suspect that it is figs and pears that mark this transition from the growing time to the harvest time.  

     The crust for the tart was sweet and crumbly, and may be my favorite part with the addition of cinnamon, cloves, a dash of nutmeg, or what ever flavors you and your family enjoys.  The crust for this tart is so good I have already made it twice in the past few weeks.  Though each were slightly different, initially being made with pears and topped with a plum- berry sauce.  Most recently with figs and no extra sauce or jam.  The pears were collected locally along with the figs used in this weeks version.  The crust was inspired by this one at My little sweet desire.
When trying to  limit dietary allergens whether they be anaphylaxis, also referred to as type one hypersensitivity, or delayed type of type four hypersensitivity, it can be frustrating with the lack of choices or feeling that one has to settle for sub par tasting food in an attempts to feel well.  I apologize if nuts are your sensitivity, unfortunately this recipe is not a good choice you.  If you try it with a different flour and have a success, please let me know. It is always helpful to know if multiple flours produce a satisfactory end product.
1/3 cup coconut sugar
1/4 cup coconut oil
1 cup almond flour
1/4 teaspoon ground cinnamon
1/4 teaspoon ground clove
2 tablespoons corn flour
4 small firm pears
5 small figs
Preheat the oven to 350 degrees Ferinheight.  Cream together coconut oil and sugar with a pie cutter or a fork.  When well combined add the remaining dry ingredients.   Press the crust into a greased 8 inch tart pan. The crust can be sticky so having a dish of water to hand to keep your fingers moist can be helpful. Place the pears and fig slices on top of the crust.  At this point they can be dusted again with ground cinnamon and clove. The pears and fig can easily be arranged in a more uniform orientation for a prettier picture.  Bake for 30-35 minutes or until the top edge of the crust is a golden brown.  Let the tart cool on the stove top for 15  minutes before removing the tart base from the side ring and resting on a cooling rack for at least another 15 minutes.
In Health,
Dr Amanda Hochman
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4 Apps that Make Eating Well Easy

     Eating well used to mean simply choosing produce over red meat, or limiting sugar or salt intake.  In today’s world, making healthy food choices does not always feel so easy.  Fortunately, with the rise in portable technologies, there are an ever increasing number of mobile applications to help individuals make better food choices.  Frequently I can be seen in the grocery store using my phone to consult with my favorite apps.  Today I am sharing my most used food apps with you.

Monterey Bay Aquarium safe fish list.  This easy to read guide is broken down into “safe”, “avoid”, and “good” fish options.  The list is not only available online, but as an app, and as a handy wallet card for those who are less techie.  Fish on this list are rated based on sustainable fishing practices and not on heavy metal or pesticide content of the fish.
Seafood Watch Pocket Guide

Fish4Health from Purdue University provides the heavy metal and pesticide data that Monterey Bay Aquarium dos not have.  The information is particularly useful for women who may become or are pregnant, and children from 2-6 years of age.  This is another app which is new to me, but features such as a log to keep track of omega 3, polychlorinated biphenols (PCBs) and mercury intake, along with recipes, it is likely to be getting a lot of use both at the grocery store and at home.

Cover artEnvironmental Working Groups Dirty Dozen:   As the name of this app suggests, this is a list of produce that are sprayed with herbicides or pesticides.  Foods that show up on this list should be organic or no spray, conventionally grown produce from this list should be avoided.
Environmental Working Groups Clean 15:  This is an annually updated list of the 15 foods least likely to be sprayed with herbicides and pesticides.  The list is available online or as a printed card, unfortunately there is not an app for this list,  though it would be helpful.

My newest favorite:  CSPI’s Chemical Cuisine.  The Center for Science in Public Interest, a support public health research, and public health policy.  This app is a list of food additives broken down into groups of “safe”, “cut back”, “avoid”, “caution”, or “avoid by some groups”.  Having a list like this is helpful when trying to understand what is in the ingredient lists of prepared foods.  

In Health,
Dr Amanda Hochman
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5 Reasons to include a wellness exam for your child before school starts

Now that we have arrived the middle of August, and summer is drawing to a close.  Families are planning the seasons last trips to the coast at Brookings in Southern Oregon or Crescent City in Northern California or maybe it is camping along the to the Rogue River.  This is also the beginning of annual preparations for the return to school for many families.  Between purchasing new clothes, shoes, technology, or other staples such as pencils and erasers, scheduling your child for a wellness exam may be neglected.

Many individuals ask what is the benefit of scheduling an appointment with your child’s  primary care provider if they are not ill.  This is a good time to develop a rapport with your child’s provider, as wellness exams may be given a longer visit length than problem focused visits.

1) This is a good time to ask questions of your child’s pediatric provider about educational or developmental assessment, if you, your child or their teachers have had concerns.  This is also a good time to initiate new therapies to help ease the transition from summer break to school.  Wellness visits are also time to ask questions or obtain information, below are  5 things you can ask your provider at your child’s next wellness exam include.

arms,athletes,balls,games,hands,leisure,men,persons,photographs,recreation,soccer,soccer balls,soccer players,sports,sports equipment,teams,uniforms2) Through the course of a wellness exam your child’s fitness for sports participation and relevant forms filled out.  It is important for your child to be healthy to participate in sports.  Additionally, this is time where preventative therapies for injury prevention can be shared to ensure that your child has a healthy and injury free sports season.

3) Take time to update your child’s family medical history if parents, grandparents or sibling have received new medical diagnoses’ in the past year.  This ensures that your child has the appropriate and relevant screening tests or interventions if there is a predisposition for heritable conditions in your family.

4)  Vaccinations for school age children. The CDC recommends a booster for measles, mumps rubella.  There is also a 3 dose vaccine gardasil, Hepatitis B for children who did not receive the vaccination series during the first year of life, and a booster for diphtheria, tetanus, pertussis vaccine.  For resources on the current rates of vaccine preventable diseases in the state of Oregon click on the link.

5)   Talking about sex and drugs may be difficult to initiate at home.  Your child’s physician can be used as a resource for accurate information about risks associated with these behaviors as well as ways to address concerns if they are present.

In Health,
Dr Amanda Hochman
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Chocolate Chip Cookies

 So what do you do on a summer day in Southern Oregon when you have to stay in the house as a result of poor air quality from forest fires?  Well, since it has been cool enough to turn on the oven, I thought cookies sounded like a good idea.  Moons ago, I was blessed with a few bags of chickpea flour, also know as besan or gram flour.  This legume flour is high in protein, and low glycemic index.  When paired with a seed these cookies not only taste great, but are a complete protein source as well, which makes them great to take as a snack with fruit and nuts when hiking or adventuring in the Rogue Valley or checking out a play in Ashland or music in Jacksonville.  If those attributes were not enough to convince you to try this recipe, they are also gluten free, vegan and paleo friendly!
One of the great aspects of this recipe is that if you too have fond memories of eating cookie batter before it has made it into the oven, this batter will surely break you of the habit.  It has to be one of the worst tasting batters I have ever tried.  It is amazing the wonders of heat and time in there ability to transform the batter into some of the best chocolate chip cookies I have ever baked.


1 flax egg
1 and 1/4  cup chickpea flour
1/2 cup sugar ( I used coconut)
1/2 tsp baking soda
1/2 tsp xanthum gum
1/2 tsp ground cinnamon
1/2 tsp ground clove
1/2 cup semi sweet chocolate chips ( carob, coconut nibs or even butterscotch can be substituted)
1/2 cup butter
2 tbsp milk or your favorite substitute


Preheat oven to 375 F

Grease cookie sheets

Sift together dry ingredients and set aside.
Cream sugar and butter.  When well combined switch to a whisk and beat until fluffy, continue beating while adding the milk and flax egg.
With out over mixing, combine the dry ingredients with the wet, before adding the chocolate chips.
Using 2 teaspoons, scoop out rounded teaspoon size balls onto the greased cookie sheet.
Bake until the edges are lightly golden brown approximately 8-9 minutes.
Remove from oven and gently transfer to a cooling rack after letting the cookies rest for 1-2 minutes on the baking sheet.

In Health,
Dr Amanda Hochman
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Safety in this time of smoke and fire

 Here in Southern Oregon the air quality has been hazardous as a result of forest fires burning throughout Josephine and Douglas counties.  In total, nearly 40,000 acres have burned. Fortunately, the temperatures have cooled and the atmospheric conditions contributing to the poor air quality have actually been beneficial to fighting the fires.  The daily Oregon Department of Forestry Reports are available at their blog.  There is an associated blog Oregon Smoke Information, where individuals can find current air quality conditions.  With the current conditions being very unhealthy, many individuals should consider wearing a mask to lessen inhalation of particulate.  The Department of Forestry has recommended the N95 and NOISH respirators.

Model 8210 N95 Mask3M N95 Respirator Surgical Masks 1860 - 5 photos
Those individuals with facial hair may need to trim to ensure that the mask fits the face securely over the face, if it does not then maximal protection can not be achieved.  If you have never worn a respirator before, it can be difficult to breath through initially, but if you relax and breath slowly you will be less likely to hyperventilate.  This is most important for those with pre-existing heart or lung conditions, however even for healthy individuals, it may feel claustrophobic.

It is recommended that individuals should limit time out of doors and stay in air conditioned locations.  Additionally, it is important for the air conditioner to recirculate the air rather than draw in air from the out side.

In Health,
Dr Amanda Hochman
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Finding self worth on the journey towards wellness

In a world filled with unrealistic images of beauty. With the pressures of an ever changing professional world.  When there are deep unfulfilled desires, it can at times to feel the divine coursing through our lives.    One can exercise, eat a whole foods organic diet, take all of the  best quality supplements and herbs, and yet, still not feel  fulfilled.  There may be an underlying difficulty in realizing that you are worthy and deserve joy.  It is time to step back and see what wounds are being carried around that are trapping and limiting our potential.  There is no reason to continue engaging in self sabotage, to taste success only to cut yourself down at the knees when you finally start to experience the life that you have been working for.

It is helpful now to take a few moments to reflect on what the original incident was that first planted the seed in your mind that you were not worth of success or good things.  I am not even going to speculate on what these incidents are for you.  Similar experiences affect all of us differently so a trivial matter for one may be devastating for another.  The important part is trying to find what the event was in your life.  When you have identified it.  If at first it does not make it self apparent, do not fear, the next step works regardless.  Close your eyes and envision a brilliant white light encircling you, as if you are inside a giant balloon or a raindrop.  Feel the light seeping into you and healing that hurt version of you identified earlier.  Or simply feel the healing energy finding the wounded version of yourself.

This healing meditation can be practiced daily to help nourish the spirit as we eat well and move to support our bodies.

In Health,
Dr Amanda Hochman
Naturopathic Physician at All Paths Naturopathy & Midwifery LLC
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Flax Pesto Potato Salad

Here in the Rogue Valley of Southern Oregon, as well as in other parts of the country the CSA boxes as of late have been brimming with beautiful vegetables. So much so that beets, and cucumbers went into a quinoa tabbouleh, flax pesto with fingerling potato salad, and the salad greens were again the soup though this time they were paired with miso and ginger rather than vegetable bullion.   The weather has been so hot in the evenings that there has been smaller than usual appetites and a bit less desire to turn on the oven.  Fortunately on Sunday I had a day of divine inspiration in the kitchen.  Having a bowl full of flax pesto sitting in the fridge just asking to be combined with fingerling potatoes in a mayonnaise less potato salad.

Flax Pesto:

1/4 cup flax – freshly ground
1 + 1/2 cup fresh basil
1/4 cup extra virgin olive oil
3 cloves of garlic peeled
1/2 teaspoon salt
1/2 teaspoon freshly ground black pepper
zest from 1 lemon
juice 1/2 lemon

Combine all ingredients into a blender or food processor.  Blitz until thoroughly combined.

For the Potato Salad

1 pound of fingerling potatos cut into 1 inch pieces
1/2 cup cooked quinoa
1/8 cup sour cream or tofutti
1/4 cup flax pesto
1/4 cup cottage cheese ( can be omitted)
1/2 teaspoon salt
1/2 teaspoon pepper
greens from 3 scallions

Boil the potatoes until fork tender.  Pour off the water and reserve for soup stocks.  Let the potatoes come to room temperature and combine the rest of the ingredients into a large bowel.  Stir to ensure that the potato pieces are well incorporated.  Enjoy right away or chilled for 60 + minutes.


In Health,
Dr Amanda Hochman
Naturopathic Physician at All Paths Naturopathy & Midwifery LLC

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Current rates of vaccine preventable diseases

This is not a piece about whether or not families should choose to vaccinate or not. Instead, it is a review of the current rates of diseases that vaccines are designed to protect against.  From a public health stand point, vaccines are designed to protect individuals through a direct immune response to the viruses and bacterium contained within the inoculation,  but also via herd immunity.  The theory that through high rates of vaccination, those who are unable to be vaccinated due to age, being immune compromised, or previous adverse reaction are also protected from the wild type viruses and bacteria.

In a number of communities including Ashland here in the Rogue Valley of Southern Oregon, families are choosing no or significantly less vaccines.  Leading to less protection for vulnerable individuals because the herd immunity is not as effective, but also there is the risk that non-vaccinated individuals are also at risk for developing a vaccine preventable disease.  As a result, it is useful to know what communicable diseases are occurring in the Southern Oregon and surrounding regions so families can make informed choices that protect themselves as well as others from exposure to or illness resulting from a vaccine preventable diseases.

 According to the Oregon Health Authorities A Monthly Communicable Disease Surveillance Report for May 2013, there have been 154 cases of pertussis also referred to as whooping cough in the state with 4 of those cases occurring in Jackson County.  Additionally, there has been 1 case of tetanus reported as well.
Farther from the Rogue Valley, in Seattle, there have been 2 confirmed cases of measles reported by Public Health- Seattle & King County in Washington state.  For individuals who may have been in Seattle or the surrounding areas July 9-10 visit Public Health website for Seattle & King County for more information.

In Health,
Dr Amanda Hochman
Naturopathic Physician at All Paths Naturopathy & Midwifery LLC
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