Integrative Medicine

Integrative Medicine

Enrique Saguil, MD

AKA

Alternative Herbal Chinese Natural Homeopathic Osteopathic Chiropractic Complementary

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

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

The “practice” of medicine in the US

Alipathic--------MD Osteopathic---DO Chiropractic---DC Podiatric-------DPM Naturopathic--ND

What is traditional?

Forms of “primitive” medicine

Chinese (acupuncturist) Ayurvedic (yogi) African (witch doctor) Native american (medicine man) Barber and blacksmith (?)

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.

12th Century Byzantine Manuscript

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

Sir William Osler, MD 1849-1919

“One of the first duties of the physician is to educate the masses not to take medicine.”

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)

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

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

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

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

Integrate traditional and nontraditional aspects of medicine

Medicines Diets Supplements Exercise prescription Stress reduction Spirituality Preventive medicine (misnomer)

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)

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)

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.

Typical office visit

History! History! History! “Bandaid” medicine review Dietary evaluation Review of exercise/ exercise prescription Stress reduction Supplement use

Testing

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

For your eyes only

Autoimmune ds Cancer Cardiovascular Cell signaling Diabetes/metabolic Hematology Hormonal Immune/inflamm

“Biophysical250” biomarkers

•Infectious disease•Nutritional•Organ system•Osteoarthritis

$3500.00

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

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.

Dr Weil’s Approach

Appendix in “Healthy Aging”

http://www.drweil.com/drw/u/ART02012/anti-inflammatory-diet

Dean Ornish’s Approach

Reverse plaque formation Reverse high psa

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

The Spectrum (controversial)

Garlic Guggul Beta-sitosterol Policosanol Pantethine Chocolate

Don’t forget: •Exercise•Stress reduction

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

Activity

Burn excess calories Condition the heart Massage the brain Assist the gi tract Stretch muscle

Exercise and weight reduction

Flexibility and exercise combo

Tai Chi Yoga

Classes at the Rush Copley Healthplex include several different forms of Yoga

Shortcuts?

Nutritional Supplements

Non FDA regulated US factory Pharmaceutical grade Cleared by banned substances control group

Exercise, diet and supplements

Every patient is different Get help from trainer, therapist RD, MD and nutritionist MD, ND or HerbalistRead! Research! Call! Redo!

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

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