Transcript Integrative Medicine

Integrative Medicine
Enrique Saguil, MD
AKA
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Alternative
Herbal
Chinese
Natural
Homeopathic
Osteopathic
Chiropractic
Complementary
Hospitals with a CAM Department
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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
Americans are involved
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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
The “practice” of medicine in the US
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Alipathic--------MD
Osteopathic---DO
Chiropractic---DC
Podiatric-------DPM
Naturopathic--ND
What is traditional?
Forms of “primitive” medicine
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Chinese (acupuncturist)
Ayurvedic (yogi)
African (witch doctor)
Native american (medicine man)
Barber and blacksmith (?)
Hippocrates
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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.
12th Century Byzantine Manuscript
Maimonides 1135-1204
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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
Sir William Osler, MD 1849-1919
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“One of the first duties
of the physician is to
educate the masses not
to take medicine.”
1st professor of medicine at Hopkins
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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)
Dean Ornish, MD
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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
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
Turning Points
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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
My turning point
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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
Basic idea
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Integrate traditional and nontraditional aspects of
medicine
Medicines
Diets
Supplements
Exercise prescription
Stress reduction
Spirituality
Preventive medicine (misnomer)
Common examples
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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)
Americans have no choice
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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)
Complementary and Alternative
improving choices
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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.
Typical office visit
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History! History! History!
“Bandaid” medicine review
Dietary evaluation
Review of exercise/ exercise prescription
Stress reduction
Supplement use
Testing
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Traditional physical exam
Standard blood testing
Specialized blood testing (spectracell)
Baseline radiology
Specific testing (stress tests, biopsy)
Alternative exams (tongue, pulse, muscle)
My Standard tests
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For your eyes only
“Biophysical250” biomarkers
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Autoimmune ds
Cancer
Cardiovascular
Cell signaling
Diabetes/metabolic
Hematology
Hormonal
Immune/inflamm
•Infectious disease
•Nutritional
•Organ system
•Osteoarthritis
$3500.00
The Antiinflammatory Diet
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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
Antiinflammatory Foods
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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.
Dr Weil’s Approach
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Appendix in “Healthy
Aging”
http://www.drweil.com/d
rw/u/ART02012/antiinflammatory-diet
Dean Ornish’s Approach
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Reverse plaque formation
Reverse high psa
The Spectrum
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Less sat fat
Fewer trans fat
Fewer simple carbs
More unrefined complex carbs
Lose weight
•Curcumin
3 gms fish oil daily
•Red yeast rice
•Niacin
Add soluble fiber
The Spectrum (controversial)
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Garlic
Guggul
Beta-sitosterol
Policosanol
Pantethine
Chocolate
Don’t forget:
•Exercise
•Stress reduction
Rush Copley Opportunities
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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
Activity
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Burn excess calories
Condition the heart
Massage the brain
Assist the gi tract
Stretch muscle
Exercise and weight reduction
Flexibility and exercise combo
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Tai Chi
Yoga
Classes at the Rush Copley Healthplex include
several different forms of Yoga
Shortcuts?
Nutritional Supplements
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Non FDA regulated
US factory
Pharmaceutical grade
Cleared by banned substances control group
Exercise, diet and supplements
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Every patient is different
Get help from trainer, therapist
RD, MD and nutritionist
MD, ND or Herbalist
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Read! Research! Call! Redo!
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Standard supplements for all
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Omega 3 fish oil
Acidophyllus
Antioxidants
Multivitamin
Antiinflammatory (unless very good with diet)
Whole foods, Second opinion, Village Herbalist,
The Herb Shoppe
Useful websites
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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