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 News Americas 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 doesnt 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
  remediesas 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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Biophysical250 biomarkers

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

• 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 Weils Approach

• Appendix in Healthy Aging
• http//www.drweil.com/drw/u/ART02012/anti-inflamma
  tory-diet

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Dean Ornishs 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

• Dont 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 Herbalist
• Read! 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