Integrative Medicine
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Transcript of Integrative Medicine
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Integrative Medicine
Enrique Saguil, MD
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AKA
Alternative Herbal Chinese Natural Homeopathic Osteopathic Chiropractic Complementary
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Hospitals with a CAM Department
Childrens Memorial Hospital Chicago Mayo Clinic Duke University Medical Center University of California San Francisco All 18 Hospitals on US New’s America’s Best
Hospitals
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Americans are involved
1997 harvard study- 629 to 386 mill 1997 21.2 billion 2002 62.1% americans used in 12 mnths Women, higher socio level, hospitalized and
former smokers (publ 2004 CDC) NCCAM funding FY 07 121.6 million
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The “practice” of medicine in the US
Alipathic--------MD Osteopathic---DO Chiropractic---DC Podiatric-------DPM Naturopathic--ND
What is traditional?
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Forms of “primitive” medicine
Chinese (acupuncturist) Ayurvedic (yogi) African (witch doctor) Native american (medicine man) Barber and blacksmith (?)
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Hippocrates 460 BC
held the belief that the body must be treated as a whole and not just a series of parts
believed in the natural healing process of rest, a good diet, fresh air and cleanliness.
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12th Century Byzantine Manuscript
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Maimonides 1135-1204
He indicates that the physical well-being of a person is dependent on his mental well-being, and vice versa
Ruled that fear and anxiety needed to be assessed before invasive medical procedures are considered
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Sir William Osler, MD 1849-1919
“One of the first duties of the physician is to educate the masses not to take medicine.”
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1st professor of medicine at Hopkins
It is much more important to know what sort of person has a disease,
than to know what sort of disease a person has…
(he combined physiological and psychological treatment of patients)
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Dean Ornish, MD
showed that a lifestyle regimen featuring meditation, a low-fat vegetarian diet, smoking cessation, and regular exercise could not only stop the progression of CAD, but could actually reverse it.
Lifestyle Heart Trial, Lancet 1990
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Andrew Weil, MD
…emphasizing prevention over treatment and focusing on nutrition, botanical medicines and mind-body interventions to complement conventional synthetic drug and surgery protocols
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Turning Points
Frustration with traditional medicine Lack of appropriate insurance Lack of appropriate medical care Intractable disease state Previous experience with alternative care Curiosity during healthy times Performance enhancing
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My turning point
Sports injuries Time spent in the Philippines (herbolarios) Exposure to Medical Acupuncture (UCLA) Patient requests Time spent in Florida (medicine of the south) Dr Andrew Weil
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Basic idea
Integrate traditional and nontraditional aspects of medicine
Medicines Diets Supplements Exercise prescription Stress reduction Spirituality Preventive medicine (misnomer)
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Common examples
Traditional medical practice Dietary evaluations (dm, lipid, gout, hbp, heart) Physical therapy (aqua, core, endurance, manual,
hand, biofeedback) Herbalist Instructor (sifu, yogi) Fung shui specialist Therapist (http://www.emofree.com)
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Americans have no choice
Obesity= 15% 1980, 27% 2002 Food industry 1 trillion Medical industry 1.4 trillion Physicians becoming technology dispensers
pressed for time Insurance doesn’t pay for wellness (diet and
exercise)
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Complementary and Alternative improving choices
NIH branch (NCCAM) Insurance pays some (+FSA and HAS)
usually chiro 2005 IRS allowed CAM deductions (acu and
chiro) Representative from Texas…"truthful health
information about supplements and natural remedies”…as a platform.
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Typical office visit
History! History! History! “Bandaid” medicine review Dietary evaluation Review of exercise/ exercise prescription Stress reduction Supplement use
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Testing
Traditional physical exam Standard blood testing Specialized blood testing (spectracell) Baseline radiology Specific testing (stress tests, biopsy) Alternative exams (tongue, pulse, muscle)
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My Standard tests
For your eyes only
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Autoimmune ds Cancer Cardiovascular Cell signaling Diabetes/metabolic Hematology Hormonal Immune/inflamm
“Biophysical250” biomarkers
•Infectious disease•Nutritional•Organ system•Osteoarthritis
$3500.00
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The Antiinflammatory Diet
Loading up on junk foods, high-fat meats, sugar and fast foods will increase inflammation in your body.
…unhealthy fats used in preparing and processing these foods, especially trans fats and saturated fats
-chemicals such as nitrites that are associated with increased inflammation and chronic disease.
Diets high in sugar have also been associated with inflammation
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Antiinflammatory Foods
Breakfast could be oatmeal served with fresh berries and walnuts, with a cup of soy milk.
Snack on whole fruits, nuts, seeds, and fresh vegetables throughout the day instead of cookies and candy.
Eat more fish and less fatty red meat. Stay away from deep fried foods and bake or stir fry your
meals instead. Choose green, orange, and yellow vegetables for your side
dishes. Drink plenty of water, fresh 100% fruit and vegetable
juices, herbal teas and green tea.
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Dr Weil’s Approach
Appendix in “Healthy Aging”
http://www.drweil.com/drw/u/ART02012/anti-inflammatory-diet
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Dean Ornish’s Approach
Reverse plaque formation Reverse high psa
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The Spectrum
Less sat fat Fewer trans fat Fewer simple carbs More unrefined complex carbs Lose weight 3 gms fish oil daily Add soluble fiber
•Curcumin•Red yeast rice•Niacin
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The Spectrum (controversial)
Garlic Guggul Beta-sitosterol Policosanol Pantethine Chocolate
Don’t forget: •Exercise•Stress reduction
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Rush Copley Opportunities
Education with your primary care doctor Education with a registered dietician ……
(630) 978-4851 clinical nutrition svc, but remember to inquire with insurance 1st
www.eatright.org
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Activity
Burn excess calories Condition the heart Massage the brain Assist the gi tract Stretch muscle
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Exercise and weight reduction
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Flexibility and exercise combo
Tai Chi Yoga
Classes at the Rush Copley Healthplex include several different forms of Yoga
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Shortcuts?
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Nutritional Supplements
Non FDA regulated US factory Pharmaceutical grade Cleared by banned substances control group
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Exercise, diet and supplements
Every patient is different Get help from trainer, therapist RD, MD and nutritionist MD, ND or HerbalistRead! Research! Call! Redo!
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Standard supplements for all
Omega 3 fish oil Acidophyllus Antioxidants Multivitamin Antiinflammatory (unless very good with diet)
Whole foods, Second opinion, Village Herbalist, The Herb Shoppe
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Useful websites
http://nccam.nih.gov/ http://www.emofree.com http://www.drweil.com/ http://www.herbal411.com/home http://www.spectracell.com/about.html http://www.hugorodier.com/index.html http://www.eatright .org