Integrative Healthcare Symposium 2015 Presented by: Jacob Hwang Doctor of Naturopathic Medicine Candidate 2016 February 19-21, 2015 New York Hilton Midtown, NY _____________________________________________________ Funded by Bastyr University Student Council Integrating Emotional Freedom Techniques (EFT) into your Practice Presented by Nick Ortner Dr. Roger Callahan combined quantum theory, kinesiology, and acupressure to help patients with phobias and traumatic stress disorders Gary Craig, a engineer at Stanford University worked with Dr. Callahan to develop a system of tapping points = EFT Integrating Emotional Freedom Techniques (EFT) into your Practice Theory or mechanism behind EFT: Tapping on the acupressure points along the meridian sends a calming signal to the amygdala Tapping helps reset the hippocampus Comparing past threats with present signals When to use EFT? Stress, anxiety, panic attacks, fears/phobias, trauma, anger, insomnia, grief/loss, enhancing self-esteem, pain management, addictive cravings. Integrating Emotional Freedom Techniques (EFT) into your Practice The tapping points: Inferior to the eyebrow towards the midline Lateral to the eyes Inferior to the eyes Inferior to the nose, but superior to the lips Inferior to the lips, but superior to the chin Infraclavicular fossa towards midline 4 inches below the arm, in the armpit Principles of Integrative Cancer Medicine Presented by Dwight McKee, MD Integrative Oncology Conventional: military style model of medicine Destroy tumor cells Traumatic, dietary concerns in calories only Complementary/Alternative: support multiple systems during intervention Increase host resistance to tumor cells and improve health Tends to have nourishing treatments with dietary programs focused on enhancing the host and “starving” tumor cells. Principles of Integrative Cancer Medicine Old view – Somatic mutation theory Cancer is a linear process: mutations occur and it grows into a tumor. The tumor needs to be removed New view – Tissue organization field theory (TOFT) by Sonnenschein and Soto Early cancers may spontaneously regress Established cancers may stay dormant The focus is on changing the terrain to prevent tumor progression and promote tumor regression http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3882065/ Principles of Integrative Cancer Medicine Effects to consider? Nutrient availability Changing the terrain/microenvironment Epigenetic mechanisms Utilizing the immune system Reduce tumor burden Immunotherapy Functional Nutrition: Transforming Patients through the therapeutic use of food Presented by Kristi Hughes, ND Director of Medical Education at The Institute of Functional Medicine “Functional nutrition emphasizes the importance of high quality foods and phytonutrient diversity to address clinical imbalances and move individuals towards the highest expression of health” – IFM Phytonutrient spectrum foods, elimination diet, cardiometabolic, detox, and energy Functional Nutrition: Transforming Patients through the therapeutic use of food G for Gather: Medical hx, ABCD (anthropometrics, biomarkers, clinical indicators from physical examination, diet journals) evaluation Nutrition status O is for Organize: PFC-MVP (Proteins, Fats/Oils, Carbohydrates, Minerals, Vitamins, and Phytonutrients) Points of Connection Pattern Recognition I is for initiate Further evaluation Nutrition care plan Patient education Never only opioids: policy trends, patient experience, and practice models in treating people with pain Moderated by John Weeks Panelists: Heather Tick, MA, MD Martha Menard, PhD, LMT University of Virginia School of Medicine study 150 in-depth qualitative interviews and content analysis of self-reported narratives with people living in chronic pain and physicians involved with medical errors Many cultivated positive attitudes while demonstrating persistence Never only opioids: policy trends, patient experience, and practice models in treating people with pain Myofascial pain Healing abilities The benefits of opioids? Acute use Chronic use History of opioid use in US Long term opioid therapy (> 3 months) Environmental Influences on Health: Research, Preventions, and Treatment Strategies Moderated by: Susan Luck, RN, BS, MA, HNC, CCN, HWNC-BC Panelists: Robert Rountree, MD Walter Crinnion, ND Devra Davis, PhD, MPH Environmental Influences on Health: Research, Preventions, and Treatment Strategies Robert Rountree, MD Save the bees: stop pesticides and use untreated seeds Colony collapse disorder Neonicotinoids: block nicotinic acetylcholine receptors of insects Most widely used pesticide in the world No data and studies War in toxicology Old school vs. new endocrinology research Environmental Influences on Health: Research, Preventions, and Treatment Strategies Walter Crinnion, ND Air pollution Possible correlation with CVD, DM, obesity, cognitive decline? Low dose exposure of chemicals We all have a toxic load 141 toxicants in everybody – CDC Every single one is a mitochondrial toxicant What to do? Avoid! Environmental Influences on Health: Research, Preventions, and Treatment Strategies Devra Davis, PhD, MPH Cell phone use Reduction in sperm count, potential carcinogen? Experts are currently advising the WHO RF exposure in phone: keep phone at least 5 mm away Air pollutant Smaller the particle, the deeper it goes Increased CV incidence Spotlight on Pain Management, Hands-on Experiential Education Presented by Hal S. Blatman, MD, DAAPM, ABIHM Pain is body’s communication of injury and damage X-ray/MRI and other diagnostic imaging do not show most injuries of chronic pain – not helpful Standard treatments generally not effective, the pain continues Spotlight on Pain Management, Hands-on Experiential Education The importance of fascia Most underappreciated tissue in the body Cleaned off in anatomy dissection Injury to fascia provides key to understanding pain Connective tissue Hard to assess damage Difficult to prove damage Spotlight on Pain Management, Hands-on Experiential Education Fascia is more innervated than muscle Myofascial pain Localized Referred Bodywork and fibroblastic activity Stressed fibroblasts secrete inflammatory cytokines for repair 90 seconds of osteopathic stretch/compression can undo inflammatory changes from a 8 hr strain Manual therapy may affect physiological responses Pediatric Mastermind: An Integrative/Functional Medicine Model for Complex Pediatric and Adolescent Cases Presenters: Lawrence D. Rosen, MD Benjamin Kligler, MD, MPH Aviva Romm, MD, CPM Functional Medicine Model Genomics, Proteomics, Metabolomics, Phenomics Prevention > Treatment Safest, most effective, and most cost-effective strategy Pediatric Mastermind: An Integrative/Functional Medicine Model for Complex Pediatric and Adolescent Cases Case 1: Asthma Benjamin Kligler, MD Increasing asthma cases? Hygiene hypothesis Dietary manipulation Milk, eggs, chocolate, soy, citrus, nuts, wheat, corn Skin testing does not correlate with clinical symptoms Elimination diet Fish oil Cochrane review shows no clear consensus regarding the efficacy of fish oil for asthma Vitamin C and lycopene moderately effective MBM for stress-related triggers for asthma Evaluating atopic disorders Pediatric Mastermind: An Integrative/Functional Medicine Model for Complex Pediatric and Adolescent Cases Case 2: Juvenile Rheumatoid Arthritis Aviva Romm, MD 4 R program Remove triggers and irritants Repair the intestinal tract: L-glutamine, aloe vera gel, DGL, marshmallow root Replace: digestive enzymes and HCl Reinoculate: probiotics Pediatric Mastermind: An Integrative/Functional Medicine Model for Complex Pediatric and Adolescent Cases Case 3: Inflammatory Bowel Disease Larry Rosen, MD IBD is a Gut-Brain-Immune syndrome Immune dysregulation Nutrition Anti-inflammatory spices, antioxidants, omega-3 fatty acids, lean proteins, fermented/cultured foods Vitamins D3, B12/folate Iron, zinc Do not use glutamine in children with IBD Botanicals Curcumin 1-4g/day in one study Aloe vera Boswellia Mitochondrial Performance – Essential for Hormonal and Organ Function Presented by Chris Meletis, ND Epigenetics in mitochondria Important mitochondrial nutrients: CoQ10, acetyl-L-carnitine, alpha-lipoic acid, carnosine, benfotiamine, riboflavin A mitochondrial foundation… Steroid hormone biosynthesis Mitochondrial dysfunction involved in most diseases Glucosamine as a new option in rejuvenating mitochondrial DNA? Many medications can cause mitochondrial dysfunction Directly or indirectly: inhibit mtDNA transcription/ETC or free radical production Unraveling the mysteries of the Eye Presented by Robert Abel, MD Study from Harvard demonstrated that doctors tend to make a diagnosis in 18 seconds Compare this to Sherlock who was always skeptical Medicine is rational/linear thinking + artistic/non-linear thinking 80% of dx can be made from patient Unraveling the mysteries of the Eye Eyes can tell you clues Relationship to different organs (brain, liver) Vision is more than just an eye trait Four stressors to the eye UV light Poor nutrition Unhealthy lifestyles Stress Eye-brain connection Connection to the world Vision Global Pain & Fatigue Syndromes Assessment and Treatment: When it is Fibromyalgia and When it is Not! Presented by David Brady, ND, DC, CCN, DACBN The different names of fibromyalgia Fibrositis, Psychogenic rheumatism Diagnostic criteria by ACR was created for research purposes Central sensitivity syndrome Perception of pain rather than a peripheral problem CFS is not FM Great FM masqueraders: sub-optimal thyroid function, myofascial pain syndrome, and sub-optimal mitochondrial/energy metabolism Effective Treatment of CFS, Fatigue, & Fibromyalgia Presented by Jacob Teitelbaum, MD, ABIHM, ABIM SHINE = Sleep, Hormones, Infections, Nutrition, Exercise as able Treatment recommendations: D-Ribose 5 g TID for 3 wks, then BID With B-complex vitamin Good quality sleep (8-9 hrs) Passionflower, wild lettuce, lemon balm, valerian, hops, L-theanine Treat hormonal deficiencies (thyroid) Promote weight loss Adrenal support Glandular extracts, Vitamin C, B5, licorice, DHEA (if low) Treat chronic infections MBM Other CAM therapies Medications for FM pain (do not use Tylenol or NSAID) Thank you for listening! For more additional questions from any of these talks, please feel free to send me an e-mail.